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VOLUME V. 



1884-1885. 



THE PEORIA 



V 



jj_y 1 



HLY 



A PRACTITIONER'S JOURNAL 



THDS, M, McILYAINEj A, M,j M, D,, 
Editor and. FuhlishEr, 



TWO DOLLARS PER ANNUM IN ADVANCE. 



PEDRI-H-j ILL., 

No, 2D4 SDutti-JEffBrsDii StrBEt, 

1BB5, 



Table OF Contents.-- Vol V. 



ORIGINAL ARTICLES. 

Anthrax W. O. Benrxj 81 

Antiseptics in Obstetric Practice Bell 72 

Aspiration of Bladder for Injury to the Urethra Anderson 407 

Absorption of Retained Placenta W. F. Millen 494 

Arsenical Treatmenc of Cancer ^ole 615 

Backaches of Women Will 537 

Bladder— Prolapse of Corbett 12 

Bladder— Prolapse of. Dodge 207 

Bowel Complaints— Vinegar in Vealch 405 

Bichloride of Mercury in Diphtheria Anderson 610 

Bichloride of Mercury in Diphtheria Tate 547 

Catarrhal Conjunctivitis Brendel 755 

Compression of the Brain by Hemorrhage Stout 749 

Cholera Wilde 761 

Cancer— Arsenical Treatment 'of Hole 615 

Case of Uncertain Diagnosis Barlow 28 

Cancer of the Stomach— Two Cases of. ieeds 287 

Chronic Dyspepsia Humiston 492 

Cirrhosis of the Liver Tale 613 

Death Odor Richardson 300 

Diaphragm— Tonic Spasm of Veatch 409 

Diarrhoea- Vinegar in Adams 412 

Diphtheria— l^rge Doses of Turpentine in A. J. Miller 476 

Diphtheria— Treated by Bi-chloride of Mercury ?a'e 547 

Diphtheria— Bi-chloride of Mercury in Anderson 610 

Dyspepsia— Chronic Humiston 492 

External Hemorrhoids — A Remedy for Leeds 28 

Klectro-Therapeutics Curtis. ^ 296-336-401 

Electricity in Muscular Rheumatism and Neuralgia -K". MiUer 343 

Emetics in the Treatment in Some Diseases of the Eye Henry 498 

FestinaLente Brendel 755 

Fracture of the Skull— Treatment of Stewart 10 

Germ Origin of Disease as Seen by a Naturalist Newlon 1 

Crlass Pessary Twenty-one Years in the Vagina Boal 20 

Olossitis Corbett 206 

Goitre •5'''od<' 612 

©all Stones— Curious Cure of Impacted Bumstead 689 

Hemorrhoids, External— Remedy for Leeds 28 

Helonias Dioica— Notes on Therapeutic Value of i' Miller 137 

Hemorrhage— Post Partum Ballard 546 

Hypodermic Injections— A Hint as to Humstead 689 

Hypodermic Syringe Geigley 752 

Idiopathic Parotitis or Mumps -B- Roskoten 677 

Impacted Fajces, Will 203 

Inversion of the Uterus During Labor Mcllvaine 296 

Iodoform asTan antiseptic Geigley 469 

I^bor— A Case of Painless J- ^- ^»"«'' 21 

Labor- Painless Skinner 154 

I<audanum Poisoning — Two Case of Keith 489 

Lupus Erythematosus TI. J. Reynolks 605 

Maggots in the Nose ..Heeiey 609 

Mjiscular Rheumatism— Electricity Jin ^"- Millrr 343 

Midwives Rhodes 614 

Mumps R.Roskoteii 677 



iv TuE Peoria Medical Monthly. 

K. MiUer 34S 
'i!:er S91 
Will 758 



Keuralffia — Ele<;tric'itv in ,., .„, 

,. ^. . „. „ ■ uciiiker S91 

J<ew ^kln Disease (.?) 



New \ork Letter 

_. . ,^, J. . Kexih 687 

Obstetric Oddities „„ 

Ovariotomv Followed l>v Acute Rheumatism '' ' 

^ . . " „ - „ Render 149 

OvariotoiuT — Case of. Recovery , . ,.. 

_ . , ,' fikiitner lo4 

Painless Labor „.,, ,„ 

^ . , . , T.S. Miller 21 

Pamless Labor 

_ . Ifnltnn i 

Pneumonia , 

Prolapse of the Bladder „,,_ 

Prolapse of the Bladder , . 

Poisoning by Laudanum — Two Cases of. ' ^,_ 

x>K„„ I 1 Hhaeftr 545 

Phenolrcamphor , . ,„ 

■a ^ n . ,T , Boliort; ;)-!b. 

Post Partum Hemorrhage 



Johnston G7i) 

IS I 

Retained Plecenta— Absorption of 



Per-oxide of Hydrogen , w k«c» 

Post Partum Drainage of the Uterus Bumstead 689 

W. F. MUlen 494 



Retained Placenta and Embryo '.'.Z S/.o«na/cer l6 

Retroversion of a Gravid Uterus Rectified by Accident Mclhaine - 

Retroversion of the Uterus litzgilbon ^,0 

Retroversion of theL'terus " " '^ ... 

Sex of the Child— can it he Predetermined ? ...Hubbard 

Scarletina '■<'"''^" '^^l 

Sel^Castration-A case of WhiUnrj L9* 

Stone in the Bladder and Kidneys Armstrong .m 

Strangulation oi Glans Penis— Recovery ilcKiuntc 49t 

Tienia Solium Sargent bM 

Tubercular Meningitis-Case of ^- iioskotcn 23 

Tapeworm Rodger., 210 

TeUnus Nascentium • f^«*^ 290 

Triplets— Placenta Previa and 31al-position Veatch 293 

Tonic Spasms of the Diaphragm Veatch 409 

Uterine Tonics Kinnenr 208 

Uterus— Post Partum Drainage of. Bumstead 689 

Vesictj- vaginal Fi.stula — Operation, Cure ^^''' -^^ 

Vomiting of Pregnancy Relieved by Pop-eorn Campbell Li 

Vomiting of Pregnancy 0. C. Reynolds 153 

Vomiting of Pregnancy nallace 87 

Vomiting of Pregnancy — Excessive Bailey -lO 

Vinegar in Bowel Comi)laints Veatch 405 

Vinegar in Diarrhaa Adams 412 

Vis Medicatrix Natura Sager 493 

Vomiting of Pregnancy — Septica-mia and Death Vealch 682 

Washing the New Born Child -Bumstead 689 

SOCIETY TRANSACTIONS. 

American Medical A.-^sociation 29 

Chicago Medical Sfx.'iety •^02 

IIJinoiM.'^tate Medical Society 42-90 

Iowa .Stat« Medical Society 95 

Pawnee County (Neb.) Medical Society 106 

MiAHOuri State Medical Society 101 

Peoria City Medical Society 33-496 

Sanitary Council of the MisxiMiippi Vallcv 692 

BOOK NOTICES. 

AddreaH in Practical Medicine 191 

AuMCuItation Percuwiion and Unnalysix 191 

Chronic Naftal Catarrh 618 

Coiui(>ectuM of Medical Colleges 619 

Courier Reriew Call Book J i417 

Cocaine '. 805 

Criminal Rcapooaibility of the luKane 191 



Table of Contents. v 

Diseases of the Urinary and Male Sexual Organs 549 

Elementary Principles of Electric Therapeutics ' 43 

Fifth Annual Report of the State Board of Health of Illinois 211 

Hooper's Physicians' Vade Mecum 89-191 

Human Osteology 618 

Illinois State Society Transactions ^^ 

Insomnia and Other Disorders of Sleep 805 

Kirke's Hand Book of Physiology 696 

Lectures on the Principles and Practice of Medicine 344 

London Medical Student and Other Comicalities 696 

Malaria and Valarial Diseases 212 

Manual of Bandagini;: ^^ 

Manual of Distases of the Throat and Nose 308 

Manual of Obstetrics 346 

Marine Hospital Report 697 

Medical Botany of North America 5^^ 

Medical Record Visiting- List 418 

M«dical Rhymes 413 

Medical Society of Tennessee 1^1 

Modern Medical Therapeutics 617 

Official Register of Physicians — Illinois 617 

Ophthalmology for the General Practitioner 87 

Pamphlets and Reprints 214-308-417-550 

Practical Manual of Obstetrics .90 

Practical Treatise on Disease in Children 345 

Sexual Neurasthenia 213 

Students' Manual of Electro-Therapeutics 213 

Text Book of P'athologieal Anatomy 308 

Therapeutics of the Respiratory Passages 549 

Transactions of the Colorado Medical Society 416 

'Transactions of Faculty of Maryland...... 416 

Treatise on Palatable Prescribing 697 

Visions of Fancy 308 

Womens' Plumbers and Doctors 619 

PERISCOPE AND ABSTRACT. 

Abdominal Section During Pregnancy 357 

.Abortion— Cleansing the Uterine Cavity after 109 

Abscess of the Lid — Strabisnaus following 115 

Abscess of the Liver 665 

Accidents— Watch for 229 

Acne — Treatment of 597 

Action of the Opium Alkaloids , 162 

Acute Alcoholism — Diagnosis of 325 

Aciite Sore Throat— Guaiac in 54 

Acute Dysentery 363 

Adherent Ulcers 793 

Adipose Diarrhoea 667 

Administration of Salicylic Acid 50 

Administration of Calomel and Potash at the Same Time 516 

Admonitory 500 

Advice to the Medical Witnesa 46 

After-birth— Removal of the 119 

Alcohol PoisoningEffects on the Heart 418 

Ammonii Boras 262 

Ammonii Phosphas 259 

Ansemia — Iron Hypodermically in 59 

Antigalactigogues 52 

Antiseptic Absorbant Sponge 121 

Antiseptic Dressing of Mercuric Bichloride 369 

Appliances for Fractured Femur 116 

Appendix Vermiformis — Treatment of Perforation 649 

Arsenic — Antidote for 380 



yi The Peorii. Medical Monthly. 

57» 

Arsenic in Epithelioma „2^ 

Arsenic in Goitre „, 

Aspirating Xoodle— Fatal Pelvic Hemorrhage from 

Asthma — Quebracho in -a^. 

Asthma ^- 

Atrophic Nasal Catarrh ___ 

Bed Sores ^-, 

Benzoated Ptisana ^.. 

Berg— On P:isteur " ^ 

B.^st Time to Administer Medicines „„_ 

o¥A> 

Bleedinir in Puerperal Cases „ 

Blepharitis Marginalis ,^«j. 

Blisters and S.Uicylic Acid in Kheumatism 

Blood Poisoning from Human Bite 

Boils — Treatment of __ 

Breast Amputations— After Treatment of 

Breast— Cysts and C>stic Tumors of 

Breech Presentation 

Brighfs Disease of Malarial Origin 

Bromine— Combined Use of the Difterent Salts of 

.. 65&' 

Bronchitis — Treatment of „_„ 

„ 37» 

B""»* ^ 221 

Burial — New Mode of 

Calomel in the Treatment of Otorrhcea 

Calomel, an Instantaneous Nerve Sedative 

Cancer — Earlv Recognition of 

u ,,", % 709 

Cancer — Pathology of 

CarlKjlic Acid- Injection for Hemorrhoids 

Carbolic Acid Poisoning 

Ctise of Insanity 

218- 



739' 



Catheters and Self Catheterism.. 



651 



Catching Cold and Other Solecisms 

777" 

Ocsarian Section by the Patient Herselt 

Chillblains ^^^ 

Chloroform Injections for Sciatica *^ 

Chloroform Ansesthesia . 

Chloroform Water ^^' 

Chloroform in Ijibor— External Use of ^^ 

Chloroforming ^^^ 

Chloral in Chorea ^^^ 

Chloral Hydrate as a Vesicant •'■°^' 

Chlorate of Potash— A Specific in Tinea Tarsi and Porrigo Favosa 31* 

Cholecystotomy " 

Cholera 24S 

Cholera— Treatment of. "^^^ 

Cholera Infantum 1^* 

Chronic Intestinal Catarrh '"^ 

Chronic Dyspepsia -^* 

Chronic Cystllis 263. 

Chronic Constipation °^ 

Cirrhf>»i8 of the Liver •^^' 

Cleansing the Uterus After Abortion 10* 

Cocaine— Additional Fields for 646- 

Cocaine— Hydr<x,-hlorate of ^■^ 

C<'>cain<; — In (jynccology ^29 

CAni&uu; — Clinical Kx|>crience "^' 

C<K.-aine in Venereal Surgery ^"* 

Co<«ine— Caution in the use of ''*''* 

Cocaine in I^aryngeal Phthisis *'28- 

Cocaine — Failurc» with '34. 

Co<;o 161 

Co«l I.ivcrOil 24& 

CoUk— Treatment of 4** 



Table of Contents. vii 

GellodioM 389 

Colorado's Climate— Therapeutic Value of 592 

Cembined Use of the Different Salts of Bromine 739 

Ccndylomata — Treatment of 230 

Consequences of Hypodermic Injections of Ether 375 

Convulsions — Morphia in ^^ 

Convulsions — Morphia Hypodermieally in 624 

Consumption — Hereditary Transmission of. '^1 

Consumption — Physical Signs of - 245 

Corrosive Sublimate in Diphtheria 1^ 

Cough in Phthisis— Treatment of. 51 

Cough of Phthisis— The 704 

Croton Chloral in Whooping Cough 740 

Croup and Diphtheria — Tracheotomy in 185 

Curare in Hydrophobia 379 

Cyanosis— Case of 377 

Cysts and Cystic Tumors of the Breast 178 

Danger of Trephining the Skull ■- 16* 

Death from One-fourth Grain of Morphia ■ 661 

Delivery of the Placenta— Historical and Critical Note on 253 

Diabetes Mellitus 240 

Diagnostic Value of Certain Symptoms in Diseases of Children 216 

Diarrhcea— Simple Kemedy in 393 

Diaphragm — Tonic Spasm of the •. 320 

Digestion — Infant 322 

Digitalis in Opium Habit 6^7 

Discovery of the Stethoscope 263 

Disinfection 659 

Dislocation of the Humerus — Reduction of. 632 

Diphtheria— Corrosive Sublimate in the Treatment of. 164 

Diphtheria — Tracheotomy in Croup and 185 

Diphtheria — Membranous and Laryngeal 225 

Diphtheria— Treatment of 513 

Diuretics— On the use of 558 

Dropsy Treated by Concentrated Solutions of Saline Cathartics 783 

Duration of Contagiousness After Acute Infectious Diseases 789 

Dysentery— Use of Large Doses of Ipecacuanha in Simple and Sloughing 175 

Ear — Worms in the 41 216 

Easy and Painless Parturition 582 

Eclecticism 56 

Eczema — Treatment of. 178 

Effects of Arsenic, Mercury and Lead on the Spinal Cord 167 

Electricity in Affections of the Stomach •• 384 

Electricity — Elephantiasis Treated by 517 

Electricity in Extra Uterine Pregnancy 515 

Electrolysis in Surgical Diseases — Value of. • 49 

Elephantiasis Treated by Electricity 517 

Elevation of a Quack, 375 

Elimination of Mercury 53 

Enlarged Tonsils 54 

Epilepsy — Treatment of 186 

Epistaxis in Children 7C0 

Epithelioma — Arsenic in 570 

Ergot in Whooping Cough 45 

Erysipelas— Universal in a Child 248 

Erysipelas — White Lead Varnish in « 373 

Erysipelas— Iodoform in 183 

Erythromelalgia — Case of - 654 

Escharotics — Painless „ 311 

Etherization— Rectal 230 

Excision of the Tonsil 236 

Expediency 261 

External Use of Chlorform in Labor 663 

External Use of Ether for Vomiting of Pregnancy 663 



viii The Peoria Medical Monthly. 

Kxtra Uterine Pregnancy — Abdominal Section 357 

Extra Uterine Pregnancy Treated by Electricity 515 

Explosive Drugs 526 

Eye And Ear Diseases Associated with Other Affections 629 

Facial Spsism 187 

FatiU Pelvic Hemorrhage from Aspirating Needle 501 

Fatality of Pericardial and Caniinc Wounds 166 

Fatality of Small Hemorrhages 164 

Feeding^Infants - 112 

First TotiU Removal of the Cerebellum in a Dog 574 

Food for the Febrile 260 

Forcible Dilatation of the Orifices of the Stomach ■ 122 

Fracture— Plaster Splints for HI 

Fracture of the Penis 530 

French Liniment 383 

Gastralgia 779 

Gaiit-rcne from Hypodermic Injection of Quinine 668 

Gastric Disease — Diagnosis of 660 

Germ Theory— Origin of 668 

German Measles 440 

Globus Hystericus 263 

Goitre— Iodoform in 712 

Gonorrliu'a 79S 

GonorrhdM— Some Facts in Connection with 435 

Gout— Mental Element in 795 

Growing Pai:i3 310 

Guaiac in Acute Sore Throat 54 

Hsemoptysis 796 

Hffimatamesis- Mechanical Treatment of 378 

Hsemorrhoids Treated by Carbolic Acid Injections 362 

Hairpin in the Uterus 669 

Hamamelis— Varicose Veins Treated with 312 

Hamamelis Virginica— Therapeutic Remarks on 560 

Headace, Spinal Irritation and Sympathetic Nerrous Affections Due to Eye Strain 774 

Heart— Nervous Derangements of the 310 

Hemorrhoids 430 

Hereditary Transmission of Fulmonarv Consumption 791 

How to Hold the Laryngoscopic Mirror 60 

How to Prepare Antiseptic Dressing of Bichloride of Mercury 369 

How to Secure Good Dental Organs, Prevent; Rickets, Hip Diseases, etc 254 

Hutchin.son's Teeth 177 

Hydrocele 262 

Hydro-(;hlorate of Cocaine in Gynecology 429 

Hydro-Chlorate of Cocaine .502 

Hypertrophied 'I'onsiJ.s- How to Shrink 518 

Hypo<-ondriasis 232 

IIyp<jdermic Injection* of Ether— Consequences of .375 

Hyriterical Aphonia 380 

Improved Method of Amputating the Penis 373 

Incidents in tlie Life of a Dintinguished Doctor 221 

Inconlinenoe of I Trine 118 

Infant Digestion 322 

Infantile Diarrhoea „ 15(j 

Infantile Paralysia— Surgical and Ortliopcdic Treatment of..., 431 

Inficlioiw Di.seaaea- Turpentine a« a Prophyluclie in 131 

IngiowingToe Nail— Trcjatment of. 262-721 

IfiManity— Cane of 3g3 

Intestinal WonndH 158 

Intra-Capular Fractures of Femur- (iuestions Respecting 393 

Intr»-f apular Fra<;tnr(! of the Femoral Neck— Bony Union In 732 

Intubation of the larynx 778 

Inversion of the IJt4-riis 346 

Inversion of the Uterus— Chrotiic 438 

Iodide of Potawium in Pneumonia 225 



Table of Contents. ix 

lodoform^Physiological Action of 662 

Iodoform in Erysipelas 183 

Iodoform in Treatment of Goitre 712 

Iodoform— Purity of— Test for •. 382 

Iron Hypodermically in Anaemia 59 

Irritable Heart 231 

Is Typho-Malaria a Special Type of Fever? 589 

Itching — Intense - 28 

Jequirity — Danger in Using !'. 242 

Koumiss^Some Facts about 237 

Labor — External Use of Chloroform in 663 

Lacerated Perinemn Treated by Single Suture 189 

Laryngeal Phthisis — Cocaine in 628 

Leucorrhcea — Treatment of 182 

Laryngoscopic Mirror — How to held the 60 

Ligation ot Common Femoral Artery 261 

Liquid Spice Plaster 381 

Liver Spots 580 

Locomotor Ataxia — Its Diagnosis and Treatment in its Pre-ataxic- Stage 765 

Locomotor Ataxia — Treatment of 314 

Lymphadenoma 326 

Malignant Tumors — Operative Delay in 166 

Mammary Abscess — Prevention and Treatment of 769 

Massage in the Treatment of Stricture 214 

Mastitis, Treated by Bandages and Rest 717 

Medical Advise by Telephone 668 

Medical Fees in the Argentine Republic. 704 

Medicine — Best Time for Administering , 352 

Membranous and Laryngeal Diphtheria 225 

Membranous Croup 117 

Meningitis — Salicylic Acid in 525 

Mental Element in Gout 795 

Menorrhagia — Witch Hazel in 183 

Menstrual Process — New Theory of 736 

Mercury — Elimination of 53 

Migraine Treated with Nitrate of Amyl 461 

Milk Diet in Gastric Ulcer 183 

Mineral Water— Artificial :.... 381 

Model Unsanitary House 121 

Moral (Affective) Insanity 44 

Morphia— Death from One-fourth Grain of 661 

Morphia in Convulsions 120 

Morphia Hypodermically in Convulsions 624 

Morjihology of Rheumatic Blood S&i 

Mortality of Married Life 223 

Mullein Plant in Phthisis GO 

Muriate of A mmonia — Uses of 577 

Muriate of Cocaine — Clinical Experience i . . . . 518 

Muriate of Coc aine in Veneral Surgery ... S21 

Nasal Catarrh — Atrophic 57 

Nasal Polypi — Treatment of 576 

Nasal Polypus— Treated by Sodium Ethylate ' 143 

Necessary Fata,lity of Traumatif Tetanus 166 

Neoplasms from a Pra> tical Point of View^ 172 

Nerve Sedative — ( ali incl an I Dr-tantaneous 258 

Nervous Derangemeiilt ui tli ■ lliart 310 

Neuroses of the Viscera ^ . . . 584 

New Test for Peptones, etc 180 

New Degrees 122 

New Mode of Burial 221 

New OflScinal Chlorate 243 

New York Authors 122 

Night Terrors in Children 595 



^ T'Hi Peoria Midical Monthly 

Kight Sweats of Fhthsis 80» 

Kinth International Medical Congresa • • 567 

Nitrite of A niyl 228 

Koeturnal Terrors in Children , 376 

Nose in Diagnosis— The 557-587 

Numbness of the Upper Extremities 442 

Oakum as a Surgical Dressing 737 

Oleate of Copper in Parasitie .-Uin Licenses 374 

Operative delay in Stmngulatt-d ITornia 165 

Openitive Delay in Acute Phlegmonous Inflgmmations 165 

Operative Delay in Malignant Tumors 166 

Ophthalmia in the Xewly-Horn— Cure for 184 

Opium Alkaloids— Action of the 162 

Opium Habit— Digitalis 647 

Oral Hygiene in the Xew Born 223 

Origin of the Germ Theory 668 

Otorrhaa— lalomel in the treatment of. 625 

Oxaluria, etc 503 

Painful Mammse in Young (Sirls 627 

Painless Escharotics , 311 

Palatable Prescriptions 315 

Pan^itic Skin Diseases— Oleate ol Copper in 374 

Partial Placenta Previa 247 

Pathological Conditions of Pelvic Disease in Women 531 

Pediatric Aphorisms 170 

Penis— Fracture of the > 530 

Peritonitis— Pilocarpine in Pleurisy and 182 

Fersi)iration of the Feet 386 

Permanganate of Potassium— Action and Uses 554 

Phenic Acid— Vaginal Application of. 247 

Phlegmonous Inflammation— Operative Delay in Acute 165 

Phthisis— Treatment of the Cough in 51 

Phthisis— Mullein Plant in 60 

Physical Signs of Consumption 245 

Physiological Action of— Iodoform 662 

Pilocarpine in Pleurisy and Peritonitis 182 

Porrigo Favosa— Chlorate of Potash a Specific 314 

Pneumonia — Iodide of Potassium in 225 

Post Fartum Hemorrhage— Vinegar in 227 

Premature Labor from Probable Fatty Degeneration of the Placenta— Repeated 698 

Pressure in the Treatment of Suppurating Buboes 220 

Pniritiia- Vcratria in the Treatment of 181 

Fudciidal Hematocele 215 

Puerperal Fever— Relations Between Micro-Organism and 189 

Pulmonary Cavities— Medical Treatment of. 626 

Pulmonary Gangrene— Treatment of Acute 573 

Pu'.monary Tuberculosis- Modern Methods in 508 

Purity of Iodoform — Test for 3S2 

<iueV)racho in Asthma 55 

Quinine— Gangrene from Hypodermic Injection of 668 

<i'"insy 359 

R'-ctal Ethcri;;ation ?. 230 

Reduction of the Dixlocation of the Humerus 632 

Relationo Between .Micro-Organi.sms and Puerperal Fever 189 

KemedieH and Their Present I'm: 422 

Removal of the Forceps Before the Head is Delivered „ 578 

Rc|>ca(ed Premature I^bor from Probable Fatty Degeneration of Placenta 698 

Retrf>-I'haryngeal AJ»ccHseH 256 

Rheumatic Blc>o<l— ,Mor|)liology of 355 

Kheumatifim — Blisters and Salicylic Acid in 366 

Rhus Poiwoning— Remedy for 227 

Rifigwonn 620 

HandtmgH for the Sick Room 632 



Table of Contents. xi 

Santonine — New Use for 168 

Salicylic Acid — Administration of. 50 

Save the Fingers 664 

Scalp Wound— Treatment of...: 226 

Scarlet Fever— How to Limit the Spread ot 122 

Scarlatina — Practical Remarks o» Treatment of Malignant Forms of 723 

Sciatica — Diagnosis of 391 

Sciatica — Chloroform Injections for 380 

Scrotal Eczema — Treatment of. 551 

Sensibility to Pain in New-Born Infants 55 

Septic£emia and Lacerated Cervix «. 59 

Severe Vomiting of Pregnancy 354 

Sick Headache 562 

Silver Hates 379 

Skin Transplantation 257 

Soft Chancer— Rapid Cure of. 388 

Some Facts About Koumiss 237 

Spinal Cord at the Region of Fourth and Fifth Dorsal Vertebrse 763 

Sprains— Treated by the Elastic Bandage 575 

Sprains— Treated by Red Clay ■ 580 

Spinal Cord — Eflects of Arsenic, Mercury and Lead on the 167 

Stethoscope-^Discovery of the , 263 

Stomach— Electricity in Affections of the 384 

Strabismus Following Abscesses of the Lid 115 

Strangulated Hernia— Operative Delay in 165 

Stricture — Massage in the Treatment of. 214 

Strychnine for Defective Vision Due to Brain Concussion •••• 6C0 

Suggestion from Dispensary Practice for Surgery of General Practice 633 

Suppression of the Urine — Tincture of Cantharides for 263 

Suppurating Buboes — Pressure ^in the Treatment of 220 

Suppurative Inflammation of the Middle Ear 594 

Surgical Erythema 631 

Surgical Delusions — Chloform Anaesthesia 163 

Sweating of the Feet— Treatment of 215 

■^ Sweating to Death „ 667 

Symmetry of Normal Wounds 160 

Tape Worm 808 

Tabes Dorsalis— Early Recognition of 433 

Tapeworm — Treatment of 176 

Tetanus Treated by Ether Spray 619 

Tetanus 379 

The Midwife 265 

Therapeutics and Materia Medica 526 

Tincture of Cantharides for Suppression of the Urine 263 

Tinea Tarsi— Chlorate of Potash a Specific 314 

Tinea Discreta or Scabies (?) 785 

Tongue — Idiopathic Convulsions of. 444 

Tonics — Abuse of 657 

Tonic Spasm of the Diaphragm 320 

Tonsillotomy 528 

Tracheotomy in Croup and Diphtheria 185 

Traumatic Tetanus — Necessary Fatality of. 166 

Treatment of Wounds 366 

Tubercular Meningitis — New Symptoms 457 

Tumors— Treatment of 705 

Tumors of the Bladc^r 648 

Turpentine as a Prophylatic in Infectious Diseases 131 

Twins Born Four Days Apart 669 

Typhoid Fever — Symptomatic Treatment of. 527-351 

Umbilical Hemorrhage 118 

Universal Erysipelas in aChild 248 

Uselessness of Treating Vicious Union of Fractures 167 

Use of Large Doses of Ipecacuaha in Simple and Sloughing Dysentery... 175 



xii The Pboria Medical Monthly. 

Ut-erine Fibroma » 178 

Vaginal Applications of Phenic Acid 247 

Varicose Veins— Treated with Hamamelis ~.., 312 

Veratria in the Treatment of Pruritus 181 

Vesicant— Chloral Hydrate as a 185 

Vicious Union of Fractures — Uselessness of Treating 167 

Vinegar in Post Partum Hemorrhage 227 

Watch for Accidents 229 

"White Lead Varnish in Erysipelas 373 

Whooping Cough 381 

Whooping Cough — Croton Chloral in 740 

Whooping Cough — Ergot in 45 

Witch Hazel in Menorrhagia 183 

Women are Dirty Creatures Anyhow 117 

Worm in the Ear 346 

THERAPEUTIC NOTES. 

Abortion — To Prevent 61 

Antispasmodic Mixture 61 

Anthelmintic 395 

Chancres and Old Sores 123 

Cholera Infantum 123 

Chorea •. 61 

Colic— Infantile 123 

Diarrhcea ilixtures — 

Chalk and Catechu 395 

Compound Bismuth 395 

Bismuth and Soda 395 

Compound Chalk 395 

Aromatic Rheubarb 395 

Coto 395 

Kino and Opium 395 

Nitric Acid 395 

Diarrhoea Mixture 123 

Dyspepsia 61 

Diarrhoea — For Summer 123 

Eczema of the Genitalia •. 61 

Expectorant Mixture 395 

Emmenagogue Pill 395 

Gonorrhoea 61 

Hemorrhoids — Local Anaesthetics for 123 

Hemorrhoids — Ointment for 123 

Lin-Dunt for Weak Back 123 

Nervous Prostration 61 

Ncur.ilgia 61 

On liitis 123 

Ovarian Dysmenorrluea 61 

Pulv. Rhei Comp 395 

Pruritus Vulva; 123 

Pulv. Alterantia Hydrarg 395 

Kheumatism , 123 

SeborrhtJBa Sicca 123 

Sexual Debility 123 

Sulphur Ointment 123 

EDITORIAL DEPARTMENT. 

A Much Desired Epidemic 467 

A New Department— Our Clinical Society — Will it Succeed? 64 

A New I>ociil A»a!Hthotic 396 

A pleasure Trip 265 

A Wail from Indiana 599 

Annals of Surgery , 466 

Afdatic Cholera 192 

Bandage for Fractared Clavicle 598 



Table of Contents. xiii 

Book Exchange Club 534 

Carbolic Acid and Aconite in Erysipelas ~.~— 742 

Chicago Jottings 132 

Cottage Hospital 803 

Crystal Pepsin 676 

De Witt County County Medical Society 803 

Dr. Von Scheweininger Again 464 

Bpileptiform Spasms Caused by Partial Atresia Vaginae 463 

Etherization by the Rectum 62 

Exhibit of Drugs 135 

Home Health 127 

How to Discontinue a Journal 803 

Important to Every Subscriber 328 

Index Medicus 745 

Instrument and Drug Catalogue 672 

Introduction of Sections into the Illinois Medical Society 124 

Koumiss 268 

Lively Times in Chicago 801 

Lively Times in Michigan 802 

Maggots in the Nose 671 

Military Tract Medical Society ^ 127 

New York State Medical Association 534 

Notes and Comments 66-128-199-265-328-388-468-535-600-673-745-804 

Obituary— WiHard Parker — Samuel D. Gross 65 

Peptonized Cod Liver Oil ahd Milk 676 

Publisher's Notice 462 

Reading Notices 202-334-806 

Receipts 66-136-268-400-467-536-604-676-748-803 

Responsibility for Payment of a Consulting Physician •■ 379 

Rush Medical College Commencement 672 

Substitute for Dovers Pow^der 127 

Tetauus, following Heaton's Operation for Hernia 126 

The Ethics of Placebos 798 

The Authority of Experience and Common Sense 63 

The Cholera 465 

The Collective Investigation Record of the British Medical Association 532 

The Question of Midwives 670 

Therapeutic Gazette 468 

Tinea Saginnati in a Child - 397 

Volume Five 800 



The Peoria 
MEDICAL MONTHLY. 



Vol. VI. : : MAY : 1885 : : No. i. 



ORIGINAL COMMUNICATIONS. 



FIBROUS TUMOR OF THE OVARY— OPERATION- 
RECOVERY. 

BY JOHN L. HAMILTON, M. D., PEORIA, ILL. 

Mrs. U., aged 34 years, married twelve years, has never 
borne children. Previous to her marriage had always enjoyed 
good health, but since has suffered some from uterine catarrh, 
for which she had been treated. 

About five years ago she first noticed a tumor on the right 
side, and called the attention of her physician to it. I was called 
soon after in consultation to examine the growth. 

I found a round, inelastic tumor, quite movable in almost 
anv direction, and about the size of a larg-e orancre. I thought, 
at that time, that it was an ovarian growth, probably cystic, but 
did not feel positive as to its exact character. I did not see her 
again for about a year, when she became my patient. On ex- 
amination I found the tumor had grown considerably, and pre- 
sented all the characteristics of a solid tumor. It was still very 
free and could be moved in any direction. She did not suffer 
much from it except in a constitutional way. Her courses were 
very irregular, six weeks and sometimes two or three months 
would pass between her periods. The bowels were obstinately 
constipated, and this gave her more pain than anything else. 



2 The Peoria Medical Monthly. 

While the tumor grew very slowly, her general health was 
gradually failing, and in February of this year she became as- 
citic. The water accumulated rapidl}^ in spite of every thera- 
peutic measure that was adopted, and her health failed rapidly, 
so that she was contined to her bed most of the time. 

About a vear ago, at mv I'equest, she visited one of the most 
eminent gynecologists of the country to get his opinion as to the 
propriety of the removal of the tumor. He advised against any 
operative interference, and gave her a discouraging prognosis if 
it should continue to grow. 

This made the case more embarrassmg to me, for while I 
had always believed that it might be removed, after his adverse 
opinion I hardly felt justified in urging it. But in the latter part 
of March the case became desperate, and I felt fully justified in 
advising the only means that appeared to give any hope for her 
permanent relief. Tapping and drawing off the ascitic fluid might 
relieve her distress and prolong life, but would have to be re- 
peated while the cause existed. She was fully aware of her con- 
dition, and realized that she could not live long unless something 
radical was attempted. 

After some hesitation she made up her mind to have the tu- 
mor removed, and accordingly on April 9th, with the assistance 
of several physicians of this city, I operated and removed a solid 
fibroid tumor of the right ovary weighing 8^ pounds. After 
drawing off the ascitic fluid to the amount of 20 pounds, I en- 
larged the incision two inches above the umbilicus, making it nine 
inches in length. The tumor was not adherent in any part, and 
the pedicle was small, though rather short. The pedicle was 
tied in the usual manner, divided, and dropped back. The ab- 
dominal cavity was thoroughly cleansed, eleven sutures closed 
the wound, and the usual dressings completed the operation. 
After placing the patient in bed she rallied quite well, although 
vomiting .some from the ether. Pulse 96, temperature 98.4. 
At 10:45 I'. M., pulse 100, temperature 100.4. From this time 
until the i ith, (;r forty-eight hours after the operation, the pulse 
ranged from 100 io 108, and the temperature remained pretty 
con.stant at 100.2. wShe complained of very little pain, and re- 
tained some boiled milk on the stomach. At 4 p. m. on the nth 
she suddenly became delirious, attemjiting to gel (jut of bed, and 



Original Communications. 3 

struggled violently. At this time the pulse was 130, temper- 
ature 104.2. She complained of considerable pain in lower bow- 
els, and severe headache. Prescribed tr. digitalis and spts. nitre. 
At 6 p. M. pulse 120, temperature 103.2. Examined the wound 
for the first time, found it looking well and not much tympanites 
present. Gave her calomel 23^ grains, to be repeated in six 
hours. Also Meigs' formula of anise, manna and sulphate of 
magnesia. Quinine, 2 grains every three hours. 

At 8:30 p. M., pulse 112, temperature 101.2; passed some 
wind by rectum. 

April 1 2th, 4 A. M., pulse 108, temperature 100. Bowels 
moved freely. 

At 8 A. M., pulse 100, temperature 99.2. Bowels moved 
five times since 4 a. m. ; gave opium and bismuth, continued the 
quinine. 

At 11:30 A. M., pulse 92, temperature 98.4. No pain, rest- 
ing quietly. 

From this time on her progress towards recovery was rapid. 
Her appetite gained daily, the wound healed by the first inten- 
tion throughout, and on the twelfth day she was out of bed, and 
on the fifteenth day was taken down stairs. There has been no 
recurance of the ascites, no pain, bowels move regularly with- 
out physic, and the patient is around the house as usual. May 
9th, her menses reappeared, the first time for over three months, 
and the third time in a year and a half. 

The sudden and violent rise in temperature was ascribed to 
malarial origin, and gave but momentary alarm. I notice that 
ovariotomists put more stress on the pulse curves than on the 
temperature, and generally expect a rise in the temperature from 
the second to the fourth days, and this I have noticed to be the 
case after m}- own operations. 

The tumor was of a solid, fibrous structure, exactly taking 
the place of the ovary, which could not be found. There were 
several small cavities near its circumferance, which gave the ap- 
pearance of enlarged Graafian follicles. 

A microscopic examination revealed fibrous structure, to- 
gether with considerable tissue resembling the stroma of the 
ovary. A more careful and exact microscopical examination 
will be made in a short time. 



4 The Peoria Medical Monthly. 

Mr. Lawson Tait exactly describes this tumor in describing 
one removed bv him in 1873.* He says: "It occupied exactly 
the relations of the left ovary. The tumor was round, smooth, 
and of a creamy white color, and it weighed nearly nine pounds. 
When cut into it had a glistening white and trabeculated struc- 
ture, and it was perfectly solid throughout. * * A number 
of sections were made, * * their uniform result being to 
show that the tumor really was the ovary, and that its over- 
growth was limited to the fibrous stroma." 

In conclusion, I am much indebted to D*-. T. M. Mcllvaine, 
who gave me much assistance in the operation, and took charge 
of the after-treatment of the case, as I was obliged on account of 
ill health to leave the cit}' soon after the operation. 

* "Diseases of the Ovary." By Lawson Tait. Fourth Ed., p. 158. 



SEPTICEMIA FROM HUMAN BITE— RECOVERY. 

BY M. WHITING, M. D., PEORIA, ILL. 

In view of the attention that has been recently given to the 
poison of human sali\a, under certain conditions, I will report a 
case which occurred in my practice a year ago. 

D. W. German, aged 22, married, sent for me in January, 
1884. On visiting him I gained the following history: Two 
weeks previously, while engaged in expelling an unwelcome 
visitor to his marital couch, he received a bite over the 2d 
phalanx of the middle finger of the right hand. The bite upon 
the dorsum was of insignificant importance and soon healed, but 
that upon the palm.ar surface remained an open sore until the 
date of my visit. 

On examination I found an ugly, foul sore over the 2d and 3d 
phalanges of the finger, the edges were thick and dark, while from 
the wound exuded a thin and very offensive purulent discharge. 
On probing I found the bone carious and exposed. The whole 
finger was tensely swollen and had been extremely painful. The 
hand was of a dark red color and oedematous to the wrist, while 
the arm was somewhat swollen, slightly oedematous and painful 
to the shoulder. Red lines marked the internal aspect of the 
forearm. Axillary glands enlarged and tender upon pressure. 



Original Communications. 5 

General condition: Tongue furred, bowels constipated, no 
appetite, high fever, temperature 103, pulse 120, weak and 
thready. Several hours before my visit he had had a severe 
chill, which was followed by a decided increase of fever. Hav- 
ing lost sleep for several nights previous on account of the pain 
in the finger and hand, his appearance was haggard and anx- 
ious. At the time of my visit he was literall}^ bathed in a co- 
pious perspiration, which had come on an hour or two before. 

Cleansing the wound as well as possible with a carbolic acid 
solution and ordering flaxseed poultices, I prescribed 4 grains 
quinia sulph. every four hours, also a laxative, and a mixture 
containing ten drops of muriate tincture of iron, with stimulants. 
This treatment was continued for three days without any percep- 
tible change in the patient's condition. During this time he had 
frequent chills, followed by an increased temperature, and a 
large blister appeared over the first phalanx, extending back to 
the metacarpo-phalangeal articulation of the finger, from under 
which offensive pus could be pressed into the wound. At this 
time I requested Dr. T. M. Mcllvaine to visit the patient and ad- 
vise concerning the amputation of the finger, which I had urged 
from the beginning of my attendance. My consultant advised 
delay in the operation, giving as his reasons therefor, the ex- 
tremely bad condition of the patient, and apprehension that the 
exposure of a large fresh surface would only give a freer en- 
trance for the septic poison into his system. He advised the 
continuance of the quinine, substituting syr. ferri iodidi in twenty 
drop doses for the tincture of iron, and the application of char- 
coal and yeast poultices to the finger. This treatment was vigor- 
ously pursued for the ensuing ten days, within which time I re- 
moved the 2d phalanx of the finger. 

At the end of three weeks the patient's condition began to 
improve, the sweats grew less, fever abated, appetite returned 
and he was able to leave his bed. The finger, however, did not 
improve much, except that the discharge was lessened and not 
so offensive. The patient now agreed to the removal of the of- 
fensive member, and accordingly, with the assistance of Dr. Mc- 
llvaine, I removed the finger and head of the corresponding 
metacarpal bone; the tissues making the flap were wonderfully 
thickened and so soft that I did not believe a suture would hold, 



6 The Peoria Medical Monthly. 

still, to mv surprise and gratification, the wound healed very 
quickly and in a few days was entirely closed. From that time 
on he made a rapid recovery, and in a few weeks more resumed 
his work. 

Dr. |. S. Carpenter, of Pottsville, Pa,, reports a similar case 
in the Medical Record of May 2, 1885. The clinical history 
of the two cases is almost identical in every respect. In con- 
cluding his article, Dr. Carpenter gives the following observa- 
tions which have the case I have reported would seem to verify : 

1. As to the nature of the disease produced by saHva. It 
is unquestionable septicccmia, which, though not fatal in the case 
reported, as with lower animals experimented on, was of so seri- 
ous a character that recovery was by no means an assured 
thing until many weeks of danger had passed by. 

2. The -pathological appearances^ which experiment deter- 
mined to "consist of a diffuse inflammatory oedema or cellulitis 
situated about and extending from the seat of inoculation," in 
the case here reported, will be seen to conform exactly, so far as 
it goes, to the description above quoted. 

3. What constitutes the difference in the virulence of the 
saliva of different individuals? The theory that nicotine des- 
troys the septic micrococcus, affirmed to be the constituent of 
saliva capable of producing disease, may experimentally be true; 
but in the case reported the man's assailant was an inveterate 
user of tobacco, which did not, apparently, influence the results 
in the case in the direction named. 

4. What factor in human saliva is it that produces the re- 
sults described? Dr. Strenberg defines it as "a micrococcus 
which multiplies in the subcutaneous connective tissue, and also 
in the blood, shortly before and after death." And the progress 
of my symptoms in the case seem to bear out this statement, as 
there was a period of incubation preceding the invasion of the 
disea.se, occupied by the micrococcus in multiplying itself, fol- 
lowed b\- the production of "the diffuse inflammatory cellulitis 
situated about the seat of inoculation and extending from it," and 
and finally producing systemic infection, which was so nearly 
fatal to tjic j-)alienl. 



Original Communications. • 7 

ECLAMPSIA IN INFANTS. 

BY O. J. ROSKOTEN, M. D., PEORIA, ILL. 
Read before the Peoria City Medical Society, May 12, 1885. 

In introducing the subject of convulsions, it is not my object 
to dilate on rare cases, abounding in curious features, but lacking 
in practical interest, nor to fully discuss the many theories which 
have been propounded to explain their occurrence when an appre- 
ciable cause could not be detected, but to confine my remarks to 
those forms of convulsions which, from their frequency, consti- 
tute a considerable portion of every physician's practice. I shall 
enter the theoretical domain onlv so far as is necessary to explain 
their production in general, rather than in a given case. 

Eclampsia in early childhood, especially until the close of 
the third year, is far more frequent than at a later age; on the 
other hand, its significance, as a rule, is much less grave. 
When we consider that in the foetus the brain is still diffluent, 
and even at birth, of such soft consistence as to be easily lacer- 
ated by the slightest violence; that until the third year its w^eight 
amounts to one-seventh or one-eighth of that of the whole body, 
while in the adult the proportion is reduced to one-fortieth; that 
up to the seventh vear it is in active growth and development 
bevond that of the rest of the svstem, receiving every moment 
new and vivid impressions, subjected to violent emotions, — under 
such conditions it is but natural that derangements in its intricate 
working mechanism should be so frequent. In this peculiarly 
predisposed state, slight affections elsewhere are often sufficient 
to evolve the effects which we now have under consideration. 
Eclampsia, which term I here restrict to clonic spasms, may be 
general or local, more commonly the former. This fact, as well 
as others, points to the existence in the brain of motor centres, 
corresponding to the various parts of the body, which centres 
must be closely connected, for we often see a case beginning 
with spasm in a circumscribed area, which soon dcAclops into 
one affecting the entire muscular svstem. Of this fact spasm of 
the glottis affords a striking illustration. 

The general motor centres would appear, from experiments, 
to be located in the medulla oblongata, while special centres are 
situated in the gray matter of the interior convolutions of the 



8 The Peoria Medical Monthly. 

hemispheres. Proofs I need not here detail. Any cause which 
renders the centres more irritable than is their usual condition, 
increases the liability to convulsive seizures. An acute irritabil- 
ity may be aroused by various transitory influences, while others 
by their continuance, keep up a state of perpetual excitation. 
This abnormal state of the medulla constitutes the predisposing 
cause, while the liberation of perverted nerve force resulting in 
convulsions, is effected b}- additional excitement derived from 
various sources. Convulsions, therefore, are the result of two 
factors operating simultaneously — i, an irritable condition of the 
medulla; 2, additional irritation from without the centre. It is 
possible that either of these factors, if working with sufficient 
energy, is sufficient. 

Before proceeding to enumerate the causes, I will, for con- 
venience of description, give the generally adopted classification 
of eclamptic attacks. 

I . Essential or Idiopathic Jlcla)iipsia, in which appreciable 
lesions, accounting for the attack, cannot be found, as after vio- 
lent emotions. 

Sxnipathctic JEc/anipsia, which occurs during the advent of 
severe constitutional or local diseases, as scarlet fever or pneu- 
monia. To this class also belong the cases produced by exces- 
sive excitement or peripheral nerves, such as obtains in intesti- 
nal disease, or the irritation by worms, or in the difficult erup- 
tion of a tooth. 

Symptomatic Eclampsia, in which the attacks can be re- 
ferred to grave disease of the nervous centres. In many dis- 
eases, however, secondary lesions of the brain, as congestion 
and effusion develop, in which cases (seen in whooping cough 
and the exhaustive diarrho^'as ), convulsions are both symptom- 
atic and sympathetic. 

Causes. — Convulsions are seen much oftener in cities, espe- 
cially in those of large size, than in the country, a fact which 
can only be explained on the hypothesis of better hygiene. 
Moreover, country people, as a rule, enjoy much ruddier health 
than those living in the citv, hence their offspring are of far 
more robust constitution. Rickets are said to be a predisposing 
factor, also. 

As mentioned above, violent emotions often suffice to induce 



Original Communications 9 

convulsions. Among these sudden fright is the most potent, 
and to a less degree, the excitement and mortification following 
a severe castigation. From it the development of epilepsy occa- 
sionally takes its start. In these the primary cause apparently 
lies in molecular changes excited in the cerebral ganglia, by 
which proper innervation is disturbed, and exaggerated nerve 
force deflected through the medulla into wrong channels. This 
disturbance in the function of a number of cerebral ganglia may 
have been so profound that, although passing off for a time, it 
may recur on trivial occasions, constituting epilepsy. More com- 
monly, however, this tendency is gradually diminished, and 
finally lost. Sudden impressions on the nerves of special sense 
occasionally result in spasms; thus exposure to very bright light, 
or the perception of a very offensive odor have been known to 
provoke an attack of eclampsia, just as some weak-nerved per- 
sons readily vomit at the sight of blood. 

It is also well known that in some families nervous disorders 
are hereditary; in such, several children may be successively 
subject to convulsions on occasions under which other children 
usuall}^ escape. As illustrating at the same time the intimate 
connection existing between the nervous systems of the mother 
and foetus during pregnancy, and the possible effects of fright, 
I will here briefly mention a case which I saw some time ago. 

A young woman was greatly terrified by a runaway team 
of horses dashing toward her; with some difficulty she reached 
a place of safety, where she dropped to the ground almost par- 
alyzed by fright. There were no convulsions. Two months 
later she was delivered of an apparently healthy child, which is 
a victim to convulsions, occurring at least ten or twelve times a 
week, unless controlled by constant medication. This must be a 
case of epilepsy transmitted to the foetus, the mother escaping. 

In attempting to explain sympathetic convulsions^ we often 
meet with difficulties. Acute diseases are usually announced in 
the adult by a''marked chill, for which in children convulsions 
are often substituted. This is common in the onset of pneumo- 
nia. If in animals, the vagus nerves are divided in the neck, 
and the central ends irritated; vomiting, convulsive respiratory 
movements, and general convulsions follow. Whether in the 
disease mentioned the cause must be sought in the inflammatory 



lo The Peoria Medical Monthly. 

changes operating on the terminations of the pneumogastric 
nerves in the hmo;, or whether the convulsions are due to the in- 
creased blood temperature and pressure in the medulla, to defi- 
cient oxygenation, or, tinally, to a narcotic principle acting as an 
irritant, circulating with the blood, or all these agents combined, 
is not settled. 

Similar conditions prevail in other diseases of the respira- 
tory passages, as in coryza of the nose, etc. 

In whooping cough, during the paroxysm, the glottis is 
closed, pressure in the chest increases, blood enters the lungs in 
small quantity, return circulation to the right side of the heart is 
obstructed, passive congestion of the brain develops; convulsions 
may, and do often, at this point, occur. Here, again, we have 
an irritable medulla, (by pertussis virus and passive congestion, 
with deficient oxygenation of blood), from which both the par- 
oxysmal cough and the convulsions originate. Cause and effect 
are here mixed. Congestion alone, artificially produced, does 
not usually provoke the spasms, and we must accept the theory 
that the specific poison of pertussis acts first on the respiratory 
centre, from which its effect, aided by congestion, may spread 
to the entire convulsive centre, situated in the medulla. 

In the eruptive fevers, such as small-pox, scarlatina, measles, 
etc., the eclampsia can only be explained on similar grounds, as 
in pneumonia and pertussis. When nursing infants are affected 
by convulsions during temporary ailments of the mother, as dur- 
ing the menstrual molimen, or when she has been laboring under 
violent emotions, their occurrence is best accounted for by the 
supposition that those influences have a material noxious effect 
on the constitution of the milk, which, causing derangements in 
the digestion of the infant, becomes an irritant to its abdominal 
nervous system. Mothers recognizing this fact withhold from 
their infants the milk secreted after a burst of passion. 

Intermittent fe\'er and ur;emia may be mentioned as occa- 
sional causes. . I have myself seen two cases of the former, in 
which the convulsions recurred in phice of the chills, as regularly 
as the latter do in ague. Peripheral irritation of various nerves 
in excitable children, forms the most frequent source of eclamp- 
sia. We cannot, of course, always detect the nerve in question, 
but diligent search will generally be rewarded with success. 



Oricinal Communications. ii 

Undigested and fermenting substances, foreign bodies, such as 
cherry stones, coins, fruit peeling, etc., in the alimentary canal, 
the irritation produced by the presence of worms, inflammatory 
diseases of the stomach or bowels, in short, anything that dis- 
turbs the abdominal organs in a child, is apt to cause an eclamp- 
tic outbreak. With the present vicious methods which ansemic 
mothers pursue in feeding their infants, stuffing them with pota- 
toes, starch and flour, sweet-meats, fruit and other food, which 
their digestive apparatus, while the pancreas is still rudimentary, 
is unable to digest, bowel troubles will continue to be the harvest 
field for the doctor. During the summer months the death rate 
among infants is excessive from acute and chronic diarrhoeal 
affections. 

In cholera infantum there is a rapid and enormous discharge 
of albuminous fluid from the body, inducing quickly a highly 
anaemic state of the blood. While at the first this results in irri- 
tation of the brain, as evidenced by crying, restlessness, tossing 
about and twitching of various muscles, there soon supervenes 
stupor, and coma. At either stage convulsions may occur, 
though the exact mode of production may vary, probably most 
commonly by aneemia of the medulla. An anaemic nerve is 
irritable, so also is a centre. While the amount of liquid passing 
through the vascular channels of the brain may be the same, its 
composition is changed; the corpuscular elements no longer per- 
form their functions readily, the centre suffers from inanition and 
tumultuous irregular action follows. Failure of the heart con- 
tributes to this condition. The same obtains in those cases in 
which the destruction of the blood is effected more slowly, as in 
cases of chronic diarrhoea, resulting in the hydrocephaloid state 
of Marshall Hall. Excessive excitation of cutaneous nerves, as 
in extensive burns, and of the uro-genital tract, such as by the 
presence of calculi in the kidney or bladder, often lead to convul- 
sions and death. Why calculi in infants should be attended with 
fatal results so commonly, is not known. 

Of the cerebral diseases it may be said that when convul- 
sions occur, they in general are due to continued irritation of the 
affected nerve ganglia and filaments by hypereemia accompanying 
the disease. In other cases, as in hemorrhages into the brain, and 
in tumors, anaemia in certain parts coexists. Hyperaemia, its ac- 



12 The Peoria Medical Monthly. 

five form, may originate from hypertrophy of the left ventricle 
of the heart, or excessive mental excitation, or any of the irrita- 
tions noticed in the consideration of sympathetic convulsions. 
The " head symptoms " thus produced must be carefully distin- 
guished from those excited by primar^^ abnormal conditions 
within the cranium, and are mostly easil}^ controlled. The pas- 
sive form of cerebral hyperaemia, as induced by dilation of the 
right ventricle, or by the pressure of swollen glands in the neck 
or thorax, or in thrombosis of the sinuses of the dura mater, or, 
more commonly seen, in great weakness of the heart during 
wasting diseases, is usually much less amenable to treatment. 

The most frequent intra-cranial disease producing convul- 
sions, is undoubtedly tuberculosis of the brain substance or its 
meninges, which cannot well be confounded with other conditions, 
since in it w^e always find other more characteristic symptoms 
and a history of previous poor health, and a family history em- 
bracing scrofulous or pulmonary ailments. 

Ordinar}' sporadic or epidemic meningitis, chronic h^^dro- 
cephalus, tumors and hemorrhage into the brain, and a disease 
analagous to spinal paralysis, atrophic cerebral paralysis, all fur- 
nish cases of convulsion, as well as too early closure of the 
sutures, malformations of the head and congenital deficiency of 
the brain. It must not be forgotten that blows and other injuries 
to the head, and disease of the middle ear, when accompanied 
by caries of the petrous portion of the temporal bone, have an 
occasional causative relation to eclampsia. 

Every physician has seen numerous cases of convulsions, 
hence I need not recite the attendant phenomena. 

The first point to decide on seeing a case, is, whether the 
seizure is due to an innocent, temporary disturbance, or whether 
a serious disease is at the bottom. A child, previously healthy, 
is seized. In the great majority of cases it is due to intestinal de- 
rangements. If little or no fever exists, inquire for the bill of fare 
for that and the preceding day. If anything to hang a suspicion on 
is elicited, give 2 to 5 grains of calomel, or if sinned in dietetics re- 
cently, an emetic. Considering that for a time the cathartic or 
emetic increases the abdominal irritation, follow early with 2-10 
grains of bromide of potassium, according to age. Sinapisms to 
the nucha, or extremities, or a warm bath, may be employed. 



Original Communications. 13 

A tooth may be on the point of breaking forth, requiring a 
sedative, or worms require an anthelmintic. If no dietetic e^ror 
can be elicited and simple irritations of a reflex character must 
be excluded, look out for epidemic diseases, malaria and acute 
inflammations. Even here I give a sufficient dose of calomel, 
with sinapisms, not for its evacuant, but for its detergent, effect. 
It is well, however, in order not to overlook possible reflex 
causes, to ask the questions according to the natural sytems in 
the body, about the alimentary, circulatory, urinary, sexual, re- 
spiratory, osseous, muscular and nervous systems. If any dis- 
turbance an3'where, however slight, is found it must be treated. 
If existing cerebral hypera^mia does not yield readily, I order 
leeches to be applied behind the ear, conjoined or not with ice 
on the head. It may be objected that in debilitating diseases 
this bloodletting would be dangerous — true, but I think that in 
such cases it will be found that instead of the supposed active 
congestion. there is reall}- an ana3mic state of the brain, whose 
symptoms ma}^ closely imitate those of the former. With this 
there exists an irritable state of the medulla. Here we must 
give heart stimulants and tonics, such as ammonia, camphor, 
musk and calisavce bark with iron, combined with remedies 
calculated to relieve the nervous state, as well as to treat the pri- 
mary pneumonia or diarrhoea. I must here remark that the 
heightened or lessened color of the face is not a safe index to the 
amount or rapidity of circulation in the cranial cavity. The 
same cause which provokes spasm can also excite a contraction 
in the muscular coats of the arteries, and thus diminish the cir- 
culation in the face, while the brain itself may be hyperasmic. 
This is often seen in persons mentally overworked. It is also 
proven by the fact that spasms (both from anaemia or hypera^nia) 
are generally preceded by pallor of the face. A much better 
guide is the convexity or concavity of the anterior fontanelle, 
wherever observations at this point are available. 

If an infant is fretful, constantlv cr3ang, with sleep disturbed, 
occasional twitchini^fs of the muscles of the face or extremities, 
temporary fixedness, or rolling of the eyeballs, flexion of the 
fingers and toes, the thumbs adducted into the palms of the hands 
and covered tightly by the fingers, we may assume that it is in 
danger of a spasm. These signs can often be noticed for hours. 



14 The Peoria Medical Monthly. 

or even a dav previous to the attack, and were we more atten- 
tive, or would insist on undressing infants for examination, we 
could often avert, or, if not, at least enhance our professional 
credit with mothers bv predicting, the spasm. In such a case we 
should give a full dose of bromide and chloral, rather than of 
opium, which might increase the possibly existing cerebral hy- 
pera^mia. Moreover, the cause should be more energetically 
treated, if diagnosed. 

It mav be advisable to give chloroform if the spasms are 
protracted or frequently recurring. It has a calmative effect 
which no other remedy can achieve so quickly. Meanwhile we 
pain time for the administration of other remedies. 

Not only are convulsions the effect, but they may also be- 
come the source of cerebral difficulties. Frequently repeated 
and violent convulsions, in which the respiratory muscles, es- 
pecially the glottis, are implicated, greatly impede the cerebral 
circulation, leading to congestion, effusion, pressure, coma and 
death. Hemorrhage, as a result of this venous stasis, is more 
rare than in adults. But thrombosis of the sinuses happens occa- 
sionally. Considering these risks, and recognizing the ineffi- 
ciencv of most remedies recommended in pertussis, I now treat 
these diseases heroically with large doses of potass, bromide, 
chloral and morphine, gradually and cautiously increasing the 
dose of the latter to -j\, or J of a grain every three hours for a 
child two 3'ears old, until the paroxysms moderate, and sleep, 
lastini; a few hours, is attained. 

The treatment of convulsions in sporadic or epidemic menin- 
gitis, comprises the exhibition of nerve sedatives, and ice to the 
head and spine. Rectal medication may become necessary when 
vomiting is obstinate. Compression of the carotids is falling into 
disuse. The prospects of preventing paroxysms in the remain- 
ing diseases of the brain or its meninges are not flattering. 
Correct diagnosis with reference to prognosis is here the most 
important consideration. If, after a fall or caries of temporal 
bone, or if, in any case, repeated convulsions Hmited to one-half 
of the bod}' and followed by partial or complete paralysis occurs, 
the inference is that some brain trouble exists. Tuberculosis of 
the brain or meninges is not usually violent in its first manifesta- 
tions: we have ample time to recognize it (more especially since 



Original Communications 15 

convulsions are a late symptom.) Such children have for weeks 
and months been in feeble health, irregularly feverish, fretful, 
morose and emaciated. If old enough they complain of head- 
aches, vertigo, noises in the head, aches and pains all over the 
body; most likely there has been a cough, with capricious appe- 
tite. There is a bad family histor}^ and sisters and brothers 
may have died of chronic disease. Ph3'sical examination shows 
chronic bronchitis, or tuberculosis of the lungs, or scrofulous 
symptoms or purulent inflammation of the middle ear. Evanes- 
cent patches of erythema are occasionallv seen. Strabismus, 
or pupillary changes, peculiar masticatory or chuckling noises, 
stiffness of some muscles, ultimately convulsions and paralysis 
may be present. 

Chronic hydrocephalus, at least in its later stages, is easily 
recognized. The signs of tumors and hemorrhage of the brain, 
and of cerebral paralysis, point so unmistakably to intracranial 
disease, that with proper care in examination we can hardly 
make the mistake of refering the convulsions to an innocent 
cause. 

The treatment of convulsions from violent emotions, when 
they recur after a variable time, embraces the exclusion and 
avoidance of all influences which are instrumental in exciting 
eclampsia in other children. Fruits and food difficult of diges- 
tion, should be withheld, every possible source of excitement, as 
by punishment, strictly avoided, and any co-existing ailment cor- 
rected. It is well to continue a moderate course of nerve seda- 
tives for a short time. The treatment of epilepsy does not fall 
within the scope of this paper. If the mother of a nursing child 
suffering from repeated convulsive attacks, is in ill-health, and 
no other cause for eclampsia be found, it should be improved, or, 
if this be not practicable, the child weaned. M3' attempts to 
assist in digestion of poor milk by lime water, pepsin, and its 
congeners, have been futile. 

I might also speak of other forms of spasms, occurring in 
young children, such as traumatic tetanus, tetanus neonatorum, 
spasm of the glottis, and idiopathic contractures (as of the toes 
or larger joints, occasionally seen as the result of reflex irrita- 
tion), but having alread}^ occupied too much time, I will post- 
pone these for a future article. 



i6 The Peoria Medical Monthly. 

TREATMENT OF SOME OF THE MORE IMPOR- 
TANT COMPLICATIONS THAT OCCUR IN 
SCARLETINA AND IN THE SEQUELS. 

BY JAS. S. WHITMIRE, M.D., METAMORA, ILL. 
Read before the Woodford County Medical Society held at Eureka, May 5, 1885. 

Mr. President and Gentlemen : — Probably among the first 
complications that occasionally occur in children affected with 
sarlatina are convulsions, carphologia and subsultus tendinum. 
The former of these is, usually, caused by an extreme irritability 
of the cerebro-spinal nervous system, which is probably induced 
by the effects of the poison germs that produce the disease, by 
their deleterious action on the blood and vital functions of the 
economy. There is no temperament nor condition in life that is 
exempt from this complication, and, therefore, we should ever be 
on the alert and ready to counteract the tendency to such condi- 
tion and to meet it promptly, should it occur. Convulsions may 
occur as one of the first indications of illness in the child, and in 
that case active and prompt measures should be used to allay the 
irritabilit}' of the nervous system. To accomplish this end, a 
hot pack is one of our best means of accomplishing this object. 
Then, to assist or act as an adjuvant to the pack, the fl. ext. 
of gelsemium, along with some of the bromides, may be given 
internally, as often and in such quantities as the age of the pa- 
tient and the exigencies of the case seems to demand, this has, 
in my hands, proved very satisfactory, and proved to be very 
efficient remedies in such cases. I would mention here, also, that 
that fi. ext. of \'eratrum viride may be given as an efficient and 
prompt antispasmodic. Carphologia and subsultus occurring in 
any stage of scarlet fever, and, in fact, in the course of any other 
disease, is always to be regarded as a grave complication, and 
when they are present they denote great irritability of the brain 
and spinal system and eminent prostration and failure of the 
vital functions. These complications are liable to occur at any 
time in the course of an attack of scarletina. The genesis of 
this condition is much the same as that of spasms; but the con- 
dition of the patient is very different; because, by this time, the 
specific poison has had time, tlirough its disorganizing influence, 
to aher the condition of the blood so as to render it incapable of 



Original Communications." 17 

carrying on and keeping up the natural sources of the vital func- 
tions; and, hence, extreme prostration and mental aberration of 
mind is the inevitable result. To meet these conditions there is 
nothing in the whole catalogue of the materia medica that equals 
the carbonate of ammonia, not only for its diffusive stimulating 
properties, but for its quieting influence over the nervous sys- 
tem; besides in any of the low forms of fever, on account of the 
enfeebled action of the heart, the blood is liable to coagulate in 
diastole, and the effect of all the ammoniacal preparations in 
is to prevent the coagulation of the blood in the heart in these 
enfeebled conditions; and, hence, to avert sudden and unexpected 
death under these circumstances. To render more permanent 
the action of ammon. carbonate, the tinct. digitalis given in con- 
nection with it would perform a most important office in giving 
force to the heart's action, and, at the same time, lessen its fre- 
quency and stimulate the kidneys to a more abundant secretion, 
which, in the end, would lessen the amount of urea iu the blood, 
and thereby avert impending and fatal coma, which would be 
imminent from uramic poisoning. The oleum terebinthina, under 
these circumstances, is entitled to our fullest confidence, in con- 
sideration of its reliable stimulating qualities and its quieting in- 
fluence over the nervous system, besides it has sometimes a most 
admirable effect in exciting the renal functions to a more abund- 
ant secretion. And last, but not least, I would not, by any 
means, ignore the stimulating influence of alcohol in some of its 
many forms; because I have, many hundreds of times, been an 
anxious and interested witness to its benign and invigorating in- 
fluence in sustaining the flickering current of life, in these cases of 
prostration, till the power of the natural functions had been re- 
stored and scored one more victory over the dark-winged mes- 
senger of Death, and gave us back our loved ones who were 
about entering the gates of the unknown beyond. I speak of a 
number of these medicaments — the most reliable — that may be 
used under the circumstances mentioned, because, under one 
condition or another, some one of them, or in combination of two 
or more, they may be applicable to some particular phase of the 
disease, that neither would separately answer the desired end; 
and for further reason that each one of them has its own pecu- 
liar physiological action on the animal economy, and the prudent 



i8 The Peoria Medical Monthly. 

physician must be the judge of the conditions, circumstances and 
extent to which thev ma}- be applied. Hemorrhage, from 
various situations, frequently occurs in the graver forms of this 
disease; from the gums, nose, kidneys or bowels, and in case this 
nemorrhagic tendency is general, the patient is liable to speedily 
succumb to the disease, on account of the exhaustion of vital 
forces : but hemorrhage from either one of these sources alone is 
not necessarily hopeless, but denotes a very grave state of the 
disease, and if this condition is general, the prognosis is not at 
all doubtful; it is inevitable death. But, notwithstanding these 
unfavorable conditions, we must not despond, but must use a 
calm and deliberate judgment in directing what shall be done in 
the premises to sustain life, and possibly, only possibly, our hopes 
may end in fruition — a life be saved and the friends made happy; 
but the favorable result may not be expected. Among the se- 
quels of this disease ma}- be enumerated a specific inflammation 
of the kidneys, articular rheumatism and external otitis; but I 
shall confine myself to the most frequent of these, which is dis- 
ease of the kidneys, producing albuminuria with its accompany- 
ing conditions, among which may be enumerated anaemia, ana- 
sarca, ascites, hydrothorax, ursemia, etc. 

It is not my purpose in this connection to speak of the ana- 
tomical character, pathological condition, causation, diagnosis, 
or prognosis in connection with these several conditions, except 
it be in an incidental or general way, in connection with the 
treatment that may be suggested. The reason for this silence is 
that everything that is known in regard to them has been abund- 
antly elucidated by all of our latest and most reliable authors who 
have written on the subject, whose works may be consulted at 
your leasure. Besides, the object of this paper is not so much 
that I expect to throw any new light upon the management of 
these cases as it is to call the attention of the younger members 
of the profession to the extreme danger there is in neglecting or 
failing to appreciate the gravity of these conditions, which are 
very frequently the sequels of scarlet fever. 

If the physician is anticipating the occurrence of acute des- 
quamative nephritis, which is likely to follow scarlatina, and is 
prompt in directing appropriate regimen and judicious treatment, 
that prognosis is almost necessarily favorable, and this for one of 



Original Communications. 19 

the most simple reasons. It is because, in the majority of in- 
stances, the recovery under such regimen will be spontaneous 
and uninterrupted; but this may not be certainly expected. 
When the eruption in scarlatina is full and complete, or whether 
this is so or not there is likely to be found more or less albumin 
in the urine, but, as a general thing, it is only coincident and 
transient, and not always significant of special danger; but when 
desquamation commences and the amount of albumin begins to 
subside, by the time this process is completed the albumin will, 
usually, have disappeared, and this more especially in the milder 
forms of the disease. But the great danger is in acute desqua- 
mative nephritis, which is usually fully developed in the course 
of from two to four weeks after desquamation is complete, and 
is not, as formerly taught, the consequence of exposure to cold 
and indiscretions, although these may be prime factors in its 
production and development in may instances. It is now known, 
however, that the disease is more frequently the result of the 
condition of the kidneys during the progress of the fever and the 
process of desquamation. So that many patients will suffer with 
acute Bright's disease under any circumstances, whether they 
have been exposed to cold or not, and its approach is so insid- 
ious that we are scarcely aware of it till the whole cellular tissue 
of the body is infiltrated with serum, and the peritoneal sac and 
pleural cavity are filled with the serous exudations from the 
blood, so as to first alarm the friends of the patient by impend- 
ing suffocation. It has been my misfortune in the course of forty 
years' practice to see many such cases. The first case that I 
ever witnessed was in my early practice, and it was under the 
peculiarly distressing circumstance connected with it that stamp- 
ed it indellibly upon my memory. I will relate the circumstance 
as it may prove of some interest to you. The case was that of 
a little girl, the daughter of Mr. Y., about six years of age. The 
family were new-comers and lived about three miles from Meta- 
mora, on the prairie, and the same distance or further from 
neighbors in any direction. I was sent for to see the child with- 
in forty-eight hours of her first illness. I recognized scarletina 
at once, and so informed the parents; but the mother insisted 
that the child could not have scarlet fever, " because," said she, 
" no one had been to the house, except the family, for a month. 



20 The Peoria Medical Monthly. 

and the child had not been away from home for more than that 
length of time." I told her that what she stated was probably 
all true, vet, nevertheless, the child had scarlet fever, and that 
the disease may have developed spontaneously^ and that I con- 
sidered the disease might be generated and developed in any 
localitv where the conditions and circumstances were favorable 
to the evolution and production of the specific poison that would 
produce the disease. (We were in those days blissfully ignor- 
ant of the germ theory.) This ended the discussion and I 
treated my little patient for five or six days for scarletina, at 
which time desquamation begun, and the child went on to ap- 
parent recovery without incident. 

I neither heard of, nor saw my patient again for about four 
weeks, when the mother brought the child to my office for ad- 
vice on account of the " great swelling of the child's limbs and 
body." Her whole body, from head to feet, was literally ready 
to burst with serous infiltration, or effusions into the cellular tis- 
sue. She had ascites, hydrothorax, hydropericardium, and could 
scarcely breathe, excepting in an erect position. I never saw 
such suffering, before or since, without pain. Let is suffice for 
me to say that I gave the mother a round scolding for her neg- 
lect of the child, and told her she should never have brought the 
child to town, as the jolting of the vehicle endangered its life. I 
prescribed for the child and sent them home, but the little suffer- 
er became asphyxiated and died before reaching that haven of 
rest. 

But, as a general thing, this character of cases do not end so 
disasterously, and, should appropriate treatment be instituted in 
time, your patients will generally recover, not speedily, but slow- 
ly and certainly, in the course of from four to six weeks. 

Among the first symptoms of the disease of the kidneys that 
you will perceive is a deathly palor of the whole surface, show- 
ing an impoverished condition of the blood — anaemia, — more or 
less puffness of the face, and particularly under the eyes, swelling 
of the feet and hands, and finally of the whole surface of the 
body — anasarca. This will be accompanied with indisposition 
to take food, pain in the lumbar region and a scanty secretion of 
urine, the specific gravity of which will be below natural, partic- 
ularly if there is a deficiency of urea, which is usually the case 



Original Communications. 21 

in this condition. A disposition to drowsiness or stupor is an in- 
dication of a deficiency in the secretion of urea, and a consequent 
increase of it in the blood; and in this case you will be on your 
guard, as ura^mic poisoning is approaching, which will be ushered 
in by coma and followed by convulsions more or less severe. 
Under these circumstances the urine will be heavily charged 
with albumin, amounting to from 25 to 50 per cent. The prob- 
able reason of the infiltration of the cellular tisues with the serum 
of the blood is, that the great amount of albumin secreted by 
the kidneys leaves comparatively nothing but water and 
fibrin to circulate with the remaining red globules, and the coats 
of the vessels, veins, capillaries and lymphatics being enfeebled 
from the want of proper nutrition, on account of the disassimila- 
tion of the albumin, and its loss by the kidneys. Hence, the 
watery portion of the blood exudes through the coats of its con- 
duits — vessels — as through a dead membrane, and fills the serous 
cavities and other tissues of the body with the impoverished 
serum. In this process of exudation, and under these circum- 
stances, it appears that the metamorphosis or molecular change 
in the tissues carries with them the nitrogenous portion of the 
disintegrated tissues into the blood and the kidneys in their dis- 
eased condition do not, as in health, separate this principle from 
the constituents of the blood, and, hence, it accumulates in the 
circulating fluid in the form of urea untill ura^mic poisoning is 
produced. It is, therefore, one of the special indications of treat- 
ment to restore the kidneys as speedily as possible to their nor- 
nal functions, and in the meantime to get rid of the accumulation 
of urea in the blood, as well as the accumulation of serum in the 
cavities and tissues of the body. To accomplish these results, it 
will be necessary to compel the bowels and skin to take on and 
perform a vicarious action for the kidneys, temporarily, or until 
such time as is necessary to restore the kidneys to a healthy con- 
dition and enabled them to perform their normal functions. The 
disease, or at least a functional disturbance of the kidneys, which 
occurs during the progress of an attack of scarletina, and which 
may continue, though in a measure latent until some favorable 
condition is developed that may bring the inflammation into an 
active stage, is, in itself, as much a specific disease, or inflamma- 
tion, as that to which it is the sequel. 



2 2 The Peoria Medical Monthly. 

It has a natural tendency to a spontaneous termination in re- 
covery, as much so as its congener, with which it is connected. 
The fact is that the greater proportion of the cases do recover 
without exciting suspicion of the disease. But when it is at first 
observed, by the cedema about the eyes and the languor and las- 
situde of the patient, then is the time to be not only prompt but 
energetic in your treatment; but you will not be called until the 
disease has considerably progressed, so as to have alarmed 
the friends. 

The indications are to remove the blood-pressure from the 
kidneys, so that they may be restored to a healthy condition. 
This is most easily accomplished by giving the sulphate or cream 
of magnesia; if the patient is ten or twelve years of age, give the 
former; if it is a child, the latter. And if the dropsical effusion 
is considerable, a dose of powdered jallap and bi-tartrate of 
potassa may be given every other day. In case the patient is a 
child of three years of age, I would give from ten to fifteen 
grains of potas. acetate in solution three or four times a day, 
and then give the following receipe: R. Aurum. and sodi. 
chlorid. gr. ss. sodi. chlorid. gr. x acid, hydro chl. gtt. iv petro- 
selium or juniperi fl. ext. dr ii syrup, simp. oz. ii. The dose of this 
would be one teaspoonful in water at each meal. 

I would then, in case uremic poisoning was imminent, and 
whether it was or not, if there was considerable anasarca, set the 
emunctories of the skin to work, not only for the purpose of get- 
ting rid of the dropsical effusion, but to eliminate the urea through 
the skin that is poisoning the nervous system. This I would 
effectually accomplish, by giving my patient, a child, from 5 to 
10 drops fl. ext jaborandi in warm water every 30 minutes, un- 
til a sudorific effect is produced. To an adult, from 20 
to 40 drops may be given in the same manner. I have had 
more experience with the alkaloid, pilocarpine, of this drug, than 
I have had with the fluid extract, and in my hands it has always 
acted promptly and satisfactorily. To promote diaphoresis while 
administering jaborandi, I have had recourse to the hot wet pack 
during the sweating stage with apparently great benefit. The 
jaborandi, or its alkaloid, should not be given for the purpose of 
its physiological action more than once in twenty-four or twenty- 
eight hours, which is to be determined by the condition of the 



Original Communications. 23 

patient, or the exigencies of the case. It must be borne in mind 
that the bowels are kept to be freely open with saline or hydro- 
gogue cathartics, as prudence or necessity may require, and 
some of the numerous preparations of iron may be required from 
the commencement, and the ferri. hydrochlo. tinct. would be 
most convenient, because it could be given in the golden mix- 
ture. External applications in the form of fomentations over 
the lumbar region should not be neglected, and dry cupping, in 
connection with the fomentations, may be used with the almost 
certaint}^ of deriving a beneficial effect. All this may appear 
like piling on the treatment tolerably thick for a regular course, 
but when it is remembered that the conditions vary in every case 
it is necessary here to give a general outline of what treatment 
may be necessary in any case, the physician being necessarily the 
judge of what may be necessary in a special case. 

Besides, my object in this cursory paper is more to call at- 
tention to what means may be used during the progress of the 
disease than it is to give the outlines of treatment in a given case. 
I cannot too urgently recommend to your favorable considera- 
tion the chloride of gold and sodium in this character of disease 
of the kidneys, following scarletina, as it seems to have a specific 
action in this class of cases and especially upon the kidneys. I 
think it has a special tendency on the elective athnity towards 
these organs, as ergot has to the uterns. It may not, like ergot, 
act upon the nerve centers governing these organs, but its ac- 
tion is, nevertheless, as noticeable in its physiological action. It 
probably stimulates the urinary secretion through its alterative, 
tonic and specific action. Then, again, in case of approaching 
uriemic poisoning, which, in these cases, is likely to occur, and 
may be recognized by the languor and lassitude denote its approach 
before the occurrence of coma, there is nothing equal to hydro- 
gogue cathartics, the hot wet pack with full doses of jaborandi 
or pilocarpine to remove the urea from the blood through the 
cutaneous enunctories. We are sometimes led to think these 
processes slow as a means of getting rid of the urea in the blood, 
but we know it is there and these are the best means at our 
command, and when they are used intelligently, they will sel- 
dom disappoint us, but prove equal to the emergency. When 
uraemic poisoning is complete, and convulsions have already oc- 



24 The Peoria Medical Monthly. 

curred. a subciitanious injection of morphine and veratrum will 
be prompt to give relief, notwithstanding its apparent contra in- 
dication from depression on account of the poison. 



OLEATE OF COPPER IN TINEA CAPITIS. 

BY ROBERT BOAL, INI. D., PEORIA, ILL. 

Among the parasitic skin diseases, few are more annoying 
to the patient, or whose treatment is often so unsatisfactory and 
perplexing to the physician, than the affection popularly known 
as scald head. Its appearance is so familiar and well marked 
that any description of it is unnecessary. Nor can it be mistaken 
for any other affection. It is called by various names, tr3^co- 
phytosis capitis, tinea circinatis, tinea capitis, and others, all 
these names having reference to the parasite which produces 
these changes on the skin. The great difficulty in curing many 
cases largely depends upon the depth and extent to which the 
parasite has propagated itself. If its ravages are confined to the 
surface of the skin, and do not reach the hair follicles, any of the 
ordinary parasiticides will generally arrest the disease; or juniper 
tea, sulphur, and other remedies of that class will suffice. But 
if the parasite has burrowed down into the hair follicles, stronger 
remedies will be required. The milder agents which have been 
named may cause a temporary improvement by destroving the 
parasites upon the suface, while those that are under it, and in 
the hair follicles are not reached. The remedy which I have 
found to most effectually destro}' these deeply hidden parasites is 
tlie oleate of copper. My attention was called to this prepara- 
tion, some two years ago, in a paragraph in one of the medical 
journals, and I determined to give it a trial upon the first oppor- 
tunity. 

Last year I was called to see a patient, 17 j^ears of age, 
well formed, robust, and in apparent good health. I found the 
entire scalp covered with large, branny scabs, from beneath 
which a discharge had issued which became hardened by the 
contact of the air, the hairs were broken off, and looked like 
stubble, ^i^he} had lost their glistening ajipearance, were dry 
and apparently dead. The eruption not only covered the entire 



Original Communications. 25 

scalp, but extended down to the upper side of the face, and over 
the ears. It was one of the worst and most unpromising cases I 
ever saw. Nearly all of the ordinary germicides had been tried 
without avail, under other hands. I determined to use the oleate 
of copper. An ointment of cosmoline containing 20 per cent, of 
the oleate was applied twice a day, having previously gently re- 
moved all the detached and partially detached branny scabs with 
a hair brush. Under this treatment the case began to improve, 
and at the end of three weeks the scalp assumed a healthy ap- 
pearance, the hair grew rapidly, and the disease was cured. 
More than a year has elapsed since that time and there is no 
return of the disease. The oleic acid with which the copper is 
combined, seems to have the power to penetrate to the depth of 
the hair follicles, laden with the copper, a combination which 
effectually destroys the parasite. 

No constitutional treatment was used or required. The oint- 
ment should be well but gently rubbed upon the parts, once or 
twice a day, as required. In most cases an ointment containing 
from 10 to 15 per cent, of the oleate of copper will be strong 
enough. In my opinion this is one of the most efficient remedies 
we possess in this troublesome and disagreeable affection. I 
shall use it in the future as in the past, with more confidence than 
any other remedy, and I do not hesitate to recommend a trial of 
it to others. 



ELATERIUM IN TYPHOID-PNEUMONIA. 

BY C. C. ALLEN, M. D., FORT SCOTT, KANS. 
Prepared for the Peoria City Medical Soeiaty. 

On January 27th, 1880, while a citizen of your countv, I 
read a paper before your society on urea and urtemic poisoning, 
in which I stated that I believed the cerebral symptoms in 
preumonia, called t3q3hoid, were of urajmic origin, and I 
related several cases which I had treated, within the two 
previous years, on this theory. Five years more experience 
proves to me that I was then correct. 

Let us take a case of pneumonia and investigate the con- 
dition of the lung at the time cerebral symptoms appear. The 



26 The Peoria Medical Monthly. 

greater the extent of the engorgement, the more certainly may 
we expect "typhoid"" S3'mptoms, and if we watch closely the 
condition of the lung, we will tind that absorption has been 
going on twenty-four to fort3'-eigl'it hours before cerebral symp- 
toms are markedly manifested. This leads to the belief that 
this deposit is, in part at least, converted into urea. 

We are often careless about the action of the kidneys in 
pneumonia, but aside from the lungs no organs should claim our 
attention more in this disease. When they are performing their 
functions properly, I do not believe that cerebral complications 
will give us much alarm since they are capable of eliminating 
urea fast enough to prevent ura^mic poisoning, and I can only 
recall but a single case in which the following treatment failed to 
relieve my patient in a few hours. 

A portion of the urea is eliminated b}^ the bowels; some say 
it is there converted into carbonate of ammonia, but I have never 
demonstrated this theory by chemical analysis; clinical observa- 
is the only test I have to offer. 

The treatment consists in such medicines as will eliminate 
urea from the blood. To trust entirely to diuretics is going too 
slowly. 

We must use something more powerful than these, and 
open up another channel for its removal, or many of our patients 
will die. This can be done by elaterium. which will carry off 
urea by the bowels with as much certainty as quinine will cure 
ague. 

I give all the diuretics the patient will bear, administering 
them internally and externally, but m}^ main reliance is upon 
elaterium, which I give in doses of from one-half to one grain 
every two, three or four hours until it operates, and then stop at 
once; for if they take too much, the bowels will operate more 
than is desirable. I only gi\'e the largest dose (one grain) so 
frequently as every two hours in extreme cases, and then expect 
my patient to wake up with the second if not with the first 
operation. 

Two cases will illustrate: 

CUisc /. Boy, three years old, right lung involved, 
Ifjwer and middle lobes well engorged. No umisual symp- 
tfmis (jccuring jii ior l(; absorption. One morning I fcnind 



Original Communications. 27 

air entering the diseased portion of the lung, at least the 
upper portion of the diseased part; this gave me much encourage- 
ment, and I informed the mother that her child was better. At 
my next visit I expected to find him rapidly approaching conva- 
lescence, and was greatly surprised to find my patient in a stupor 
from which he could not be aroused. After learning from the 
mother all that I could, I did as I alw^ays do with small children; 
watched him closely for a few minutes. I soon concluded that 
if this was not ura^mic poisoning I was not capable of diagnosing 
the disease at all. Special inquiry revealed the fact that he had 
not passed any urine for thirty hours. Introducing a catharter, 
I drew off not to exceed four ounces of urine. This gave me 
more faith in my diagnosis, and I treated the case accordingly, 
increasing the diuretics and giving one-fourth of a grain of 
elaterium every two hours, ordering it stopped as soon as the 
cathartic effect was produced. In the evening I found him wide 
awake and perfect rational; had taken three doses which had 
operated live times. He was not concious with the first opera- 
tion, but called to be taken up with the second, and remained 
awake. This free catharsis did not weaken him and he made a 
rapid recovery. Was this arousing the effect of the medicine or 
was ft only a coincidence ? 

Case 2. Was called to see Mr. B., aged 19. Found a well 
marked case of pneumonia involving right lung. Nothing un- 
usual presented itself in this case until after absorption began, 
when in twenty-four hours he became stupid and a well marked 
case of typhoid pneumonia developed. Treatment was the same 
as in the last, except that I gave one-gram doses of elaterium 
every two hours. Next day found him all right, had roused up 
with the first operation and had no more "typhoid" symptoms. 
Discharged him in three days. In this case the kidneys had 
almost ceased to act. 

The case above referred to, in which elaterium failed to give 
the least relief, was a peculiar one. Patient was a man aged 
about forty. Whole right lung became entirely hepatized, yet 
there was but little cough, no expectoration, only a slight increase 
in temperature or frequency of the pulse. He smoked much of 
the time, laughed and joked with his friends and always said he 
felt first-rate, and his friends hardly believed me when I informed 
him of his danger until the cerebral symptoms came on. 



28 The Peoria Medical Monthly. 

Elaterium failed to give any relief, as did everything else, 
and he died on the thirt3'-second da^-. I could get no evidence 
from auscultation that absorption was taking place at any time. 

This was the most pecuhar case that I have ever seen, and 
I have always been sorry that I did not bleed him as soon as the 
typhoid t3^pe became well marked, as it would have partially re- 
lieved the brain from the effects of the poison contained in the 
blood. 



ACUTE EPIPHYSITIS WITH OSTEOMYELITIS; AM- 
PUTATION OF THE LEG — RECOVERY. 

BY J. T. STEW^ART, M. D., PEORIA, ILL. 

F, G., a boy aged thirteen years, complained of a little pain 
in his left ankle, on the evening of March 26th. Was called to 
see him in the afternoon of the 27th, found no fever, no redness 
or swelling of the ankle, the joint movable but painful. Think- 
ing he was suffering from a slight sprain which he may have 
gotten unawares, I prescribed an anod3'ne lotion and rest. Two 
days later was called again and found him in a high fever, his 
ankle very much swollen and red, extremel}^ tender and painful. 
A dozen leaches were applied, followed by poppy-head fomenta- 
tion and suitable general treatment. This for a time somewhat 
palliated the symptoms, but the disease went on unchecked. 
The inner side of the leg began to swell out and to assume an 
erysipelatous character, which rapidly developed into a large 
abscess. This was freely laid open on the 6th of April. A 
large quantity of ill conditioned pus was discharged. A few 
days later it was demonstrated that the whole shaft of the tibia 
was dead from the maleolus for four inches up. Dr. Murphy, 
w ho had been called in council, and myself, then informed his 
father that an amputation w(nild probably be necessar3\ On the 
I Slh, Drs. Wise and Loughridge were added to the council. The 
necessit}' for an amputation was so plain there was no difference 
of opinion, and we so informed his father, but it was not until 
the 20th, when the case was becoming dc'S|-)erate, that consent 
could be obtained to operate. On the afternoon of the 20th, 
assisted by Drs. Murphy, Roskoten and DuMars, I ojurated 
through tlie upper third of the leg; just t\vent\-hve da3's from the 



Original Communications. 29 

time he felt the first pain. On dissecting the leg the epiphj'sis 
was found to be entirely separated from the shaft of the bone. 
The shaft for four inches up was denuded of periosteum, dead 
and lying in a sop of pus and sanious matter. The epiphysis 
was a mass of disease, and so soft that it could be broken up be- 
tween the thumb and fingers, and the articular surface of the 
astragalus had already become diseased. The disease in this 
case evidently began in the epiphysis and rapidly extended to 
the tibia and into the joint. The boy was not conscious of hav- 
ing sprained or injured his ankle in any way. 

He is of a scrofulous habit, and his father informed me that 
for two months previous to his sickness, he had not been looking 
or feeling quite well, though, all this time he attended school. 

Twenty-four hours after the amputation be began to 
improve. His pulse which had been running from 120 to 160, 
and feeble, gradually grew less frequent and gained in strength. 
His tongue gradually lost the firey redness which had character- 
ized it for two weeks. His temperature which had ranged from 
103 to 105 became normal. His appetite came to him in an 
incredibly short time. The stump healed as kindly as possible. 
It is now just four weeks since the amputation, and two dimes 
will cover all the points that are not cicatrized. 



SEPTIC POISONING CAUSED BY THE WATERY 

DISCHARGE FROM THE BOWELS OF A 

DEAD SUBJECT. 

BY W. H. TATE, M.D., GREENSBURG, OHIO. 

Too great emphasis cannot be placed upon the importance 
of having the hands perfectly free from abrasions of the skin, or 
sores of any description whatever, by persons who have the hand- 
ling of dead bodies, whether it be in holding postmortems, or 
simply dressing the dead preparatory to burial. 

On February 24th, 1885, whilst Mrs. G., an old lady who 
died of apoplexy, was being washed for interment, one of the 
ladies who was present, was called upon to assist in cleaning the 
body, and having previously a small scratch on the ring finger 
of her right hand, but not regarding it, happened to get some of 



30 The Peoria Medical Monthly. 

the watery discharge that flowed from the bowels of the subject, 
into the abrasion. On the following da}^ it was observed that 
the linger had assumed a red appearance, and also slight pain or 
smarting. In a day or two more the pain and redness had in- 
creased to an alarming extent, extending as far up as the shoulder 
and back of the neck. 

Having poulticed it with various kinds of poultices, and 
getting no relief, after a delay of three or four days, I was re- 
quested to prescribe for the hand. I ordered a flax seed meal 
poultice to be applied, saturated with a ten per cent, solution of 
permanganate of potash, which was kept up for several days. 

Good results were manifested after the second or third 
application, and in a week or ten days the hand was restored to 
its former condition and usefulness. 



CORRESPONDENCE. 

New York Letter — Studies of Medical Men. 

New York, April loth, 1885. 

Dear Doctor: My opportunity for studying the medical 
men of this city has been confined principally to those in the gy- 
necological field. As your readers well know, there be those 
here who have a world-wide reputation in that branch of our 
profession, and well deserve it, too. 

In all departments of human endeavor are found workers of 
particular prominence. Some are leaders: men of advanced 
thought, of superior ability, and of extraordinary energy — ^one 
or all. Others, again, seem to have had a modicum of great- 
ness, as it were, thrust upon them : men who have become more 
or less notorious through accident, rather than deserving per- 
sonal effort. In these respects the department of the science and 
art of medicine and surgery is no exception. We have our truly 
i^real men, and our notorious men, and I, like people in general, 
take an interest in watching and studying them. Of the individ- 
ual : his appearance, manners, the peculiar attributes of his prom- 
inence, the circumstances under which he has grown and may- 
hap flourishes, are all objects of the more or less keen analytical 
perceptions of his fellows. 



Correspondence. 31 

One of the former class in this city is Dr. T. Gaillard 
Thomas, a man well-known to every intelligent medical man in 
the civilized world. Dr. Thomas I found to be a man of prepos- 
sessing appearance; of medium height, quite stout and heavily 
built, inclined to corpulency. He has a well-rounded head, in- 
clined to baldness, keen eyes and firmly-set mouth. He wears a 
full, moderately cropped greyish beard, slightly parted in the 
middle and brushed to either side. He is a man of dignified ap- 
pearance and manner, and not given to conversation of a scatter- 
ing character. I take him to be a strictly methodical man, very 
decided in manner, courageous, and withal quite fully impressed 
with his own professional worth. The latter reference I do not 
make in the line of disparagement, for people nowadays in their 
estimation of a man, persist in taking into account fully his esti- 
mation of himself, tempered as it should be by real worth, a be- 
coming modesty, and an evident desire to give due credit to 
others. 

Dr. T. is always full of business, as indicated in his move- 
ments. His firm tread and prompt decision indicate a well-bal- 
anced mind and a clear appreciation of the value of time and the 
necessity, so to speak, of " sticking to the text." He spends but 
one hour and a half each day at his office on Fifth Avenue. The 
remainder of his time, aside from that devoted to study, being 
spent in private and consultation practice throughout the city, ex- 
clusive of the hour spent at the College of Physicians and Sur- 
geons, the time necessary in his duties as attending physician to 
the Woman's Hospital, and the claims of his own private hos- 
pital, or sanitarium, as he calls it. I was particularly anxious to 
see the latter, and found it a marvel of perfection, indicating in 
its arrangement and appointments, the man's love of scientific 
exactness. The building was erected with a view to its fitness 
for the purpose of a private hospital for the wealthier classes. 
Its exact size I do not know. It is a pressed brick and stone- 
faced structure, five stories high, with a south and east frontage. 
There are no openings in the building, either to the north or 
west. The halls are on the blind side, and extend its full length 
on each floor. Every room in the building gets the sun during 
some portion of the day, and an abundance of light all the time. 
Each room has its ventilating shaft, with openings near both floor 



32 The Peoria Medical Monthly. 

and ceiling, and gas jets within to create a current. The floors 
are of hard wood, the walls and ceilings hard finish and destitute of 
pictures or trimmings, or other ornamentation, except lines in 
fresco. The minor operating room for simple applications, elec- 
tricit}', etc., is a marvel of neatness, compactness, and efficiency 
of arranofement. An elevator at the rear end of the building and 
in connection with all the halls, gives easy access to all parts of 
the house. There are no permanent wash-basins or water-clos- 
ets inside the building, thus excluding all sewer connections. 
Washing utensils are furnished and removed by the nurses, when 
necessary, and the closets are reached by a protected passage- 
way out from each floor. The building is lighted by the incan- 
descent electric fight, so as to avoid the effects of combustion on 
the atmosphere. On the top of the building is a glass house for 
sun-bath purposes, and one for massage. Also on the roof is a 
promenade, where patients can take the necessary exercise with- 
out any particular attention to the toilet. No nurses or other 
employes are permitted to sleep in the sanitarium proper, but 
have their accomodations in another building, separate and apart 
from that of the latter, but connected with it by a covered pass- 
age-way. Likewise the operating room for the major operations, 
such as ovariotomy and the fike, is separated from the main 
building and is a wonder of convenience and hygienic precau- 
tions. The room is so arranged that it can be tightly closed, 
and after each operation is fumigated and disinfected by the com- 
bustion of quantities of sulphur. 

The hospital has accommodations for forty-one patients, and 
is always full, or nearly so. The charge per week for board and 
nursing is $40, with medical attendance extra, in the amount of 
from $25 upwards, depending upon the necessities of the case, 
and includes three visits per week from Dr. Thomas, attention in 
the mean time being given by the physician in charge. Dr. 
Chambers, to whom I am indebted for kindnesses shown, and 
who is a perfect gentlemen. Absolute obedience /;/ every ■partic- 
ular^ is demanded of every person admitted, and if any hesitancy 
is manifested, admission is refused. 

I have thus discussed from my main subject, thinking that a 
description of such a perfectly arranged institution would be as 
interesting to my readers as to myself. I could not help think- 



Correspondence. 33 

ing, however, when considering the advantage of such an 
establishment, to what a great extent they would be enhanced if 
the latter were placed upon an elevation similar to the brow of 
one of the grand bluffs overlooking our beautiful Illinois, instead 
of being nestled amongst the piles of brick and mortar, and 
buried in the heavy atmosphere of the noisy city. 

As an operator Dr Thomas is very speedy, and seems to 
think the latter quality an element of success. I saw him per- 
form an ovariotomy completed in twelve minutes, and extirpate 
a very large sarcomatous uterus, by abdominal section, all com- 
plete in twenty-five, with all its circumstances of detail and 
uncertainty. Assuring himself of the correctness of his diagnosis, 
he exhibits no tendency to hesitation, but immediately acts in 
the direction most likely in his judgment to be of advantage to 
the patient, regardless of possible unpleasant results; acting, as 
he remarked to me on one occasion, " not in the interests of Dr. 
Thomas, but in the interests of the patient." 

Dr. T's. operative clinics are remarkable for the strict dis- 
cipline and order, which he maintains in his surroundings. 
While it is possible for one with sufficienc "cheek" to force his 
way into nearly every other hospital clinic, it is not possible to 
do so to those of Dr. Thomas. Tickets of admission signed by 
himself, are absolutely necessary to secure their advantages. 

The efficiency and speed attained by him in his operative 
proceedures are largely due to his system of carefully trained 
assistants, both male and female, and the systematic arrangement 
of them and their aruiamentariuni. On-lookers are compelled to 
keep at a convenient distance, all routine appliances and possible 
necessities are kept within easy reach, and the different assistants 
are expected to anticipate constantly the operator's wants. 

Dr. Thomas' professional literary work has been confined 
almost entirely to the production and revision of his volume on 
" diseases of women," which has been well received throughout 
the world, and as he is not yet by any means an old man, he bids 
fair to have his usefulness extended over many years to come. 

Who has not heard of Dr. T. A. Emmett ? Amongst those 
who have forced their way to undeniable eminence and power in 
the profession, at home and abroad, he stands without, perhaps, 
a peer. Dr. Emmett is a man of superior social qualities in his 



34 The Peoria Medical Monthly. 

intercourse with his professional associates. Perhaps somewhat 
above the medium height, he is of stout build, although not at 
all flesh}'. He is well proportioned, having a full round head, 
closely shaven face, sparkling eyes, pleasing open countenance, 
suave and courtly in manner, cordial but dignified, is, in tine, a 
perfect gentleman in every respect, in so far as I have been able 
to discover. He is seemingly a man of strict decorum, apt in all 
observations of all the amenities of his profession, and exhibiting 
the greatest interest in the results of work on the part of his 
associates. Dr. E. is original in his methods, a close observer, a 
persistent worker, and tenacious of his rights. His work on 
gynecology is one of the best known professional publications in 
the English language, and in its latest revised form deserves all 
the praise which is bestowed upon it. Dr. E. is a careful, far- 
sighted operator, and the results of his labor have been brilliant. 
It is in originality of method and research, however, in which Dr. 
Emmett excels; but that about him which most quickly and 
forcibly impresses and gains the good will of strangers is the 
suave, graceful and courteous manner which he exercises toward 
all with w^hom he is brought in contact. Indeed, I would like 
to remark that nowhere have I encountered an exhibition of 
more courtesy and polite consideration than is practiced amongst 
the associates in the Womens' Hospital' of this city. 

One of the most energetic men in the gynecological ranks 
here is Dr. Paul F. Munde, the well known editor of the 
American yom-nal of Obstetrics. He is a comparatively young 
man, not more than forty, I should say, and a German by birth. 
He is a man of medium height, round head, very dark complex- 
ion, black hair cut short, black mustache, and smoothly shaven 
chin and cheeks. He is very active in his movements and 
possesses superior business ability. Dr. Munde was a pupil of 
the celebrated Scanzoni, and in that capacity made the acquaint- 
ance of prominent medical men of Europe and the Continent. 
It is said that when he assumed the editorship of the 'Journal of 
Obstetrics, he drew upon his acquaintances in the East for con- 
tributions and ancouragement, and the result was that the 
Journal, from being a periodical of a few hundred subscribersj 
quickly jumped into the position of one with thousands, and 
became an authority on both continents. Dr. M., thus made 



Correspondence. 35 

the Journal's reputation and his own at one and the same time. 
' Dr. Munde is an excellent observer and a good writer, but 
as a lecturer is rather too prolix, and as an operator too hasty 
and rough. Nevertheless he is one of the most devoted men I 
ever saw, and has a large and lucrative practice. He is 
gynecologist to Mount Sinai Hospital, and professor of gyneco- 
logy in the Polvclinic Medical School, and is perhaps as much 
as any one the originator of the latter. Dr. Munde is a man of 
fine social qualities, and professionally quick to accept sugges- 
tions and confer due credit. His work on minor surgical 
gynecology is well known as one of the volumes of Wood's 
library for 1880. A revision of that work has been accompHshed 
by him, and will soon be on sale, in which, as he informs me, he 
will include something on some of the major Operations in 
gynecology. One may feel assured that whatever Dr. Munde 
undertakes to do in that line, will be well done, and deserve the 
confidence of the profession. He beheves in no half-way work. 

More anon. 

Truly yours, 

O. B. Will, M. D. 



THE SPINAL CORD AT THE REGION OF THE 
FOURTH AND FIFTH DORSAL VERTEBRyE. 

Editor Peoria Medical Monthly : 

In the last April No. of your Journal, you quote Dr. A. 
Harking as saying in substance, that there is a normal tender- 
ness of the spinal cord within the fourth and fifth dorsal 
vertebrse, and that many physicians not having recognized this 
tenderness as being normal, have applied vesicants or blisters over 
this region with success in the relief and cure of various diseases 
named, erroniously supposing that the spinal cord was diseased in 
this region, and that there was peculiar virtue of applying the 
vesicants or blisters over this region. I would say from experi- 
ence, that I believe a vesicant or blister applied on the arm- or 
chest of the patient, would in the majority of cases have done 
as much good as if it had been applied over the fourth and fifth 
dorsal vertebra, and I would further say that I would give as a 



36 The Peoria Medical Monthly. 

reason of the relief and cure in the majority of the cases named, 
that I gave on page 481, vol. II., of vom- Journal for the cure of 
intermittent fever. 

Silas Hubbard, M. D. 



LICHEN AGRIUS. 

Editor Peoria Medical Montldy : 

In reply to Dr. Oettiker's query relative to a new skin 
disease, published in the March No. of your valuable Journal, 
allow me to say through your columns, that there is no 
better analogy between the Doctor's experience and my own, in 
the treatment of this disease, at the time my attention was first 
called to it, some four or five years ago. 

For the first year I found it a very difficult matter to arrive 
at a correct diagnosis, from the description given in the text 
books on " diseases of the skin," consequently my treatment was 
as varied and uncertain as my diagnosis. 

The eruption (in this disease) is of the papular variety, or 
classification, in color not differing materially from the skin, 
discrete, and about the size of rape seed, situated on the exten- 
sors of the fore-arm, thigh, breast and abdomen. 

It is characterized by itching, which is more intense on 
going to bed at night. 

We sometimes find it a difficult matter to distinguish 
lichen agrius from scabies, as the former may become in violent 
or neglected cases, a scabby, confluent eruption, with cracks and 
fissures and perhaps a purulent discharge. 

Still if we bear in mind that scabies is found mostly in the 
line of flextion, while the affection under consideration presents 
the best marked lesions in the fine of extension, and that while a 
glass of ordinary magnifying power, we are able to find the 
mite, cuniculus or burrow of the little animal which will 
establish the diagnostic distinction between tlie two affections. 

The combined influence of irritation and lack of cleanliness 
constitutes the main etiological factors. 

As to treatment, I shall be brief. I place my patient's on 
Donavan's solution, (liq. arsenici et hydrargyri iodidi) in eight 



Correspondence. 37 

to ten drop doses three times daily, largely diluted with water. 
Locally I use the following: 

R Ung. hydrag, nitrat. 

Ung. petrolei aa M 

Sig. Apply to the eruption at bed time, after cleansing the 
surface of the body with soap and warm water, and wiping the 
skin dry. 

The improvement that follows in a few days speaks for 
itself. Respectfully, 

L. L. Bond, M. D. 

Wesl Side, Crawford Co., III., May ig, 188"^. 



WAS MERCURY INDICATED.^ 

Indianola, III., April 16, 1885. 

Editor Peoria Medical Monthly : 

A few weeks ago I was called to see an elderly lady who 
was sufferincr with a chronic entero colitis of several months 
standing. She was anemic and presented evidence of a broken- 
down constitution. After the usual remedies had failed, con- 
sultation was requested. Dr. R. was called and suggested the 
use of mercury in small and frequent doses until a slight degree 
of ptyalism was induced. To this I objected, and a third phy- 
sician was called who expressed his opinion that calomel was the 
only remedy that would likely save life. To such a course I 
could not assent. My patient had a weak and thready pulse of 
100, frequent and copious evacuations, and every symptom 
contraindicated the use of mercurials, either as a dipletive or 
" alterative." 

I allude to this case as an example of the reckless and in- 
discriminate use of mercury. It is prescribed in all conditions 
by many who have fallen into that narrow, routine practice of 
giving calomel, opium and quinine indiscriminately, whether the 
patient be sthenic or asthenic, and continue it until ireparable 
damage is induced. It is the sheet anchor with man}^ in all 
febrile disorders attended with a dry tongue. They recognize 
this to be evidence of torpidity of the digestive tract, or the so- 
called " billions condition," and it must be counteracted with a 



38 The Peoria Medical Monthly. 

mercurial, even if it be a case of typhoid fever. So it becomes 
a panacea with them and is abused more than any other remedy 
in our materia medica. 

Patient after patient is salivated, and their svstem so im- 
poverished with mercury that they never recover from the 
effects of it. In many conditions it is the remedy par cxccUcncc^ 
but there should be a line drawn somewhere. As an antiphlo- 
guistic it is one of the most valuable remedies at our command; 
that it affords powerful aid in controlling the action of the heart 
and blood vessels is unquestionable, but where is the judicious 
practitioner who would dare use it as an antiphlogistic in persons 
of a strumous habit of body, in the old, or the infirm. 

The administration of mercury should never be made unless 
there seems to be a special indication for its use, and no judicious 
physician will use it heedlessly and recklessly without a due re- 
gard for results. He knows it is a remedy for good or evil, and 
he therefore employs it wisely and properly; opportunely, and 
not out of time. 

F. N. Odbert, M.D. 



PERISCOPE AND ABSTRACT. 

THF TREATMENT OF CARBUNCLE WITHOUT 

INCISION. 1 

A recent severe and somewhat striking case of carbuncle 
treated without incision has recalled a number of cases similarly 
treated, which excited some little interest among physicians who 
had watched the cases at my clinics and elsewhere, and has 
suggested the propriety of presenting the subject on this 
occasion. While the avoidance of a cutting operation in car- 
buncle is by no means a new suggestion, I feel sure from my 
experience in and intercourse with the profession, that the far 
more general practice is to make the free incisions so commonly 
recommended in many text books, and that the plan here 
advocated differs in many respects from that usually employed. 
I will first present in brief the case referred to: 

Judge aged 56, a large, florid gentleman, with deli- 
cate skin, first came under treatment for a very moderate amount 

1 I{«a<l in the Section of Pra<'tice of Medicine, Mutt-riii Mcdioa, and PliVHiolofO', Ajiril 28, 
1885— By L. Duncan Hulkley, M. I)., New York. 



Periscope and Abstract. 39 

of eczema upon the left leg and foot, which had existed to a 
greater or less degree there and elsewhere for five or six years. 
He had generally enjoyed good health, but stated that he had 
had diabetes for some time, in varying degree; he had not slept 
well since a period of nervous exhaustion several 3'ears previously. 
He was an excessive smoker. The eczema ^nelded remarkably 
well and quickly to an alkaline tonic, and an ointment of camphor, 
bismuth, and white precipitate. 

Six weeks after his first visit he returned complaining of 
pain in the back of the neck on the right side, and on examina- 
tion a red, hard, boggy mass was found, between an inch and 
a half and two "inches in diameter, in either direction. This was 
moderately elevated, was apparently an inch in thickness, and on 
the surface were several small pustular points; it had existed 
several days before his visit. He was given quarter grain 
sulphide of calcium pills, gelatine-coated, one of which was to be 
taken every two hours, irrespective of meals. Locally he was 
directed to keep the entire surface, and over an area of nearly 
three inches, covered with lint, with the following ointment 
spread very thickly on the wooly side: 

R Ext. Ergotte fid 2 drs. 

Zinci Oxidi 1 dr. 

Unguent. Aqure Rosse 2 ozs. 

This dressing was to be renewed twice daily, or oftener if there 
was much discomfort. 

Three days later he called at the office, with the parts very 
thoroughly covered with the dressing; the boggy mass had 
increased in size, and was fully three inches in diameter, and the 
pustular openings, four in number, were more apparent and 
discharged some pus, in the largest of these, in the centre of the 
mass, a small portion of slough was seen. He had had consider- 
able dull heavy pain the night of the visit, but the ointment was 
very comfortable, and gave much relief when it was freshly 
applied. His pulse was 90 and of medium strength, the tongue 
was rather white and coated, and the bowels had been consti- 
pated but had since acted well. He was directed to continue 
the granules of sulphide of calcium every two hours, and the 
following mixture was given: 

R Magnesia Sulphatis 6 drs. 

Ferri Sulphat 1 dr. 

Acidi Sulph. dil. 3 drs. 

Hyr. Zinzib 1 oz. 

Aqute ad 3 oz. M. 

Take one teaspoonful after eating, three times daily, through a tube. 

Three days later he again called at the office; the mass had 
increased still in size, and measured nearly four inches trans- 



40 The Peoria Medical Monthly. 

versely; there were now five openings, the central one of some 
size, from which a large amount of pus escaped. He had had 
some pain, but had been down town daily, attending to his 
business, although the nights were somewhat restless. His 
pulse was then 78 and of good strength, and the temperature 
beneath the tongue was 100.** The examination of the urine 
since the previous visit showed a specific gravity of 1.026 in the 
morning specimen, and 1.044 "^ ^^^^^ passed at night, in both 
there was amorphous urates and a trace of albumen, and in the 
night specimen there was a considerable amount of sugar. The 
treatment was continued, with the addition of ten grain Dover 
powders, to be taken as required for sleep. Locally the oint- 
ment was still applied. 

Two days later, or eight days from the first day of treat- 
ment, the record was made that much of the hardness of the 
carbuncular mass had gone, that the area of the mass had 
diminished to three inches in diameter, and that pus of a healthy 
character could be pressed in some quantity from the central 
opening, which was about one-third of an inch in diameter, 
partially occluded by a grayish slough. He had slept well, 
taking three powders the night of visit, but none since. The 
treatment had been carried out faithfully in every particular; he 
he had gone to his business daily. 

Three days later all inflammatory appearance and soreness 
had gone from the mass, which was, however, still somewhat 
hard over an area of an inch and a half to two inches ; pus exuded 
from the openings, of a thick, healthy character. As the bowels 
were a little constipated an extra dose of the magnesia and iron 
mixture was given in a tumbler-full of hot water, before break- 
fast. Some boil-like masses which had formed upon the thighs 
had dried up, and he was feeling in excellent health and spirits. 

His next visit was one week later, or eighteen days from 
the first visit. Three days previously a slough had come out of 
the central opening, nearly an inch in length, following which 
had come quite a gush of rather watery pus, as though it had 
been corked up within. The carbuncular mass had almost 
disappeared, and at the time of the visit there was scarcely any 
hardness, but some redness remained, with a little watery dis- 
charge from two small openings. Ten days later the only trace 
of the carbuncle was a small scar left by the central opening, 
perhaps a third of an inch in diameter, and a little general red- 
ness of the neck. 

During this previous week he had been passing considerable 
amount of urine, about three pints during the night, and as 
much during the day. The morning specimen stood at 1.0355 
and the evening at 1.038. The morning specimen contained a 



Periscope and Abstract. 41 

considerable quantity of uric acid in large crystals, and abundance 
of oxalate of lime; the evening specimen had a trace of albumen. 
Both specimens contained sugar in abundance, the morning 
specimen between three and four per cent., and that passed at 
night, at least live per cent. 

We have here the history of a carbuncle of fully an average 
size and severity, in an elderly subject v\^ith pronounced diabetes 
mellitus, running a comparatively short course, giving com- 
paratively little constitutional disturbance, and not interfering 
with the daily attention to business. During the entire treatment 
there was no surgical interference, other than the slightest 
pressure occasionalh', simply to learn of the amount of pus 
present, and not to evacuate it. The inflammator}- process 
terminated in the production of openings through the skin which 
were sufficient to allow the escape of the pus, and the slough 
which formed was largely dissolved, and but a single mass 
remained, which escaped spontaneously through an opening 
hardly half an inch wide. 

The treatment employed was that which I have followed 
repeatedly, for several years past, and as far as I can 'J^ossibly 
recall, with uniform success. Modifications may be required for 
particular cases, but in the main the principles of treatment are 
the same, and mav be brieflv detailed. 

Locally I strongly objected to warm applications, such as 
poultices, repeatedly replaced them by that above mentioned, 
with the greatest relief to the patient. From the first I order 
the application of an ointment, spread very thickly upon the 
wooly side of lint; the layer of ointment should be a third of an 
inch at least in thickness, and should not be spread too hard 
upon the part. It is often desirable to place a layer of absorbent 
cotton outside the lint, and beneath the outside wrap, to make a 
softer dressing, and to take up any pressure or blow upon the 
part. This dressing is to be continued from the beginning to 
the end, being renewed as often as comfort or cleanliness 
demands. 

In regard to the constitution of the ointment, I regard the 
ergot as an important element, and in certain cases where it was 
desirable to use it in a greater proportion in the ointment, I have 
prescribed the solid extract in place of fluid, as used in this case. 
The zinc I believe has also somewhat of an astringent effect, and 
the rose ointment I regard as superior to ordinary or benzoated 
ointment, as being much more soothing. Sometimes the heat of 
the part will be so great as to cause the ointment to melt away 
rapidly; it may then be made more solid with a greater proportion 
of white wax, or with the addition of diachylon ointment. 



42 The Peoria Medical Monthly. 

The internal treatment employed in this case was also that 
which I consider to be of importance in this condition. There 
can be no question in regard to the power of sulphide of calcium 
in checking suppuration, and its power is often ver}- strikingly 
manifested in carbuncles; one-sixth or one-quarter of a grain, 
riven every two hours, is a very valuable aid in their treatment, 
but the article must be good and etRcient, for there is danger 
lest an inert preparation be emplo3'ed When the drug is exposed 
to the air it changes into the sulphate of lime, or gypsum, which 
is valueless. It is best, therefore, always to use it in gelatine- 
coated pills, and these should be frequently tested by cracking 
them in the mouth. 

The mixture of sulphate of magnesia, iron, and sulphuric 
acid is also important, as I believe, both of its tonic and refriger- 
ant effects upon the skin, and also probably because of the 
increased amount of sulphur thus introduced in an assimilable 
form. It acts somewhat as a laxative, and its dose may be 
increased as required; taken in hot water before breakfast, it 
generally acts on the bowels very effectually. 

It will be seen in this case that no specially supporting 
treatment was given; the patient was directed to take good, 
nourishing food, and no stimulants. I am convinced that 
stimulants would better be avoided when possible, though, of 
course, in special cases they may be absolutely demanded in 
order to support life where there is great sloughing and suppura- 
tion. I will not occupy time with any extended consideration of 
the subject of carbuncle and its treatment as presented in 
literature, as the matter is familiar to all. Many plans of treat- 
ment have been suggested, most of them, however, looking in 
same direction, namely, toward giving artificial relief to the 
distended tissues, by incision, caustic openings, cupping, etc.. 
Some have urged pressure, and various counter-irritants have 
been suggested, but I can find no mention of such a plan as here 
presented, of a soothing and astringent ointment being applied 
from first to last. 

In recalling earlier cases in which I had practised free 
crucial incision, as commonly advised, with subsequent poultic- 
ing, and the large slough often formed, with its slow healing and 
subsequent scarring, together with the attendant pain and 
discomfort, and comparing them with later cases, treated as here 
detailed, I am more than convinced that incision should be 
avoided if possible. I feel conlident that absorption frequently 
takes place through the wounded blood vessels and lymphatics, 
r>ften inducing blood changes, which does not occur when 
nature; makes the opt-ning. sealing the vessel as it proceeds. 



Periscope and Abstract. 43 

The points of importance in the treatment of carbuncle, as 
here advocated, may be summed up as follows. 

1. The very careful avoidance of all unnecessary irritation 
of the inflamed surface, as by friction, pressure, handling, 
squeezing, etc., both during the earlier and later stages. 

2. The avoidance of all warm and moist applications and 
dressings, such as poultices, etc., from the first to the last. 

3. The avoidance of incision, the entire process of opening 
and discharge of the pus and slough being left to nature. 

4. The avoidance of stimulants, except in cases absolutely 
necessary to sustain life and strength. 

5. The perfect protection of the inflamed part, from first 
to last, by means of an ointment (perferably one containing 
ergot and zinc) thickly spread upon lint and charged as often as 
comfort and cleanliness require. 

6. The administration from the first of sulphide of calcium 
in small doses, every two hours, great care being taken to secure 
an active and strong article, that in gelatine-coated pills being 
the best. 

7. The support of the system, not by stimulant food 
and medicine, but by securing a healthy performance of the 
function of the system, with nutritious and healthful food, with 
fresh air, and every agent which can aid to this end. 

8. The remedies required are an occasional laxative, a 
slight sedative, such as Dover's powder, at time, to procure 
sleep, and a refrigerant and tonic, such as is found in a mixture 
of sulphate of magnesia, sulphate of iron, and sulphuric acid. 

The advantages observed to follow this hne of treatment 
■ may be briefly stated : 

1. A comparatively short duration of the entire process. 

2. A comparatively small amount of pain. 

3. A comparatively small amount of scarring. 

4. The avoidance of a surgical operation. 

5. The avoidance of detention in bed. 

In conclusion I would add, however, that the plan of treat- 
ment here advocated is not put forth as that which will 
invariably be successful, although in my hands it has yielded 
infinitely better results than any other! The duration of all the 
cases has been comparatively short — in the case here detailed it 
was hardly three weeks from beginning to end. Dr. Moore, in 
Ashurst's surgery, stated that the average time of healing in 
thirty-five cases, in St. Bartholomew's Hospital was about seven 
week, while several months were sometimes required where the 
destruction of tissue was large. Certainly the pain and discom- 
fort attending the cases treated on the plan here proposed has 
been very slight compared to that in others which I have 



44 The Peoria Medical Monthly. 

treated by other methods. I shall look with interest for reports 
from others who may give trial to this plan of treatment. 

DISCUSSION. 

Dr. James F. Hibberd, of Richmond, Indiana, cordially 
indorsed the ver}- valuable paper which has just been read. He 
formerly treated his patients with all the approved surgical 
measures recommended for carbuncles, but for more than twenty 
years he had made no incision, crucial or otherwise, into a 
carbuncle. He had also abolished poultices whenever he was 
allowed to do so. Friends generally believe, however, in 
poultices and each one of the family has his favorite one to 
advocate. x\bout a 3'ear ago Dr. Hibberd was treating a 
patient who had one large carbuncle on the back of his neck and 
two small ones near it. It occured to him to apply oleate of 
morphia in the hope of mitigating the pain during the further 
developement. The oleate was applied by gentle friction every 
three hours. Patient returned in forty-eight hours with great 
improvement and diminution of pain. In four or five days the 
pain was all gone, and recover}^ took place without any appear- 
ance of suppuration, or breaking of the skin. A small lump 
alone marked the original seat of trouble. This case was 
followed by several others, which were treated in the same 
manner and with the same result. 

Dr. Williams, of Nashville, testified to his success in 
treating carbuncle without incision. He gave one patient half a 
gallon of whisky per day. No preceptible effect from the 
whisky was observed by the patient until the carbuncle became 
better, when he perceived the influence of the liquor. 

Dr. J. V. Shoemaker, of Philadelphia, has used the follow- 
ing for external application : 

R Naphthol 10 ^r. 

Ext. of arnica ^ oz. 

Oleate of lead 3 oz. 

This produces a very soothing effect. He has failed to 
obtain such good results with the alkaloid oleates, as have been 
reported by other observers. 

Dr. Savage, of Jacksonville, surrounds every carbuncle 
with a zone of cantharidal collodion for from one-half to one inch 
in width; this draws a blister and relieves pain. He makes a 
small incision, also, if pus has formed. In one case he appled a 
cantharidal plaster over the whole tumor and extending beyond 
it, with excellent results. He gives calcium sulphide internally, 
a (juarter of a grain four times daily. 



Editorial Department. 6i 

Congress from coming to the United States in 1887." Now as 
Dr. Jacobi is the only new code man on the general committee 
he ver}^ pertinently requests an explanation from Dr. S. So far 
he has failed to receive it and he is consequently vexed in spirit. 
Dr. Shoemaker should rise and explain. 

The next meeting of the Illinois State Society will be held 
in Bloomington. 

" No money can be made out of dead men " says a Chicago 
pathologist. He has evidently forgotten the undertaker. 

The Medical Record says that, " When a poor medical col- 
lege feels particularly poor it opens its doors to women." 

The " devil " in our printing office says this number of the 
Monthly is going to be a " dandy." What do you think of it ? 

The Weekly Medical Reviezu no longer has a Chicago ed- 
itor. Jealousy, we presume at the "other end of the big bridge" 
is the cause. 

The average attendance at the Cincinnati Academy of Med- 
icine is from 18 to 20 out of a membership of over 100. The 
Peoria City Society averages about 15 out of a membership of 
about 25. 

The American Journal of the Medical Sciences is to be 
published in England simultaneouslv with its appearance in this 
country. Dr. M. Morris w^ill be the English editor. 

About 150 members and delegates attended the late meet- 
ing of our State Society at Springfield. What a small number 
for a state with over 4,000 regular physicians! 

We will furnish reprints of articles sent us at cost of paper 
and presswork, which will average about 75 cents per page for 
300 copies. The order for reprints must always be given v^hen 
the article is sent to us. 

Chambers & Co. of St. Louis are to be congratulated on the 
elegant make up of The Annah of Surgery. In contents, pa- 
per, type and everything that goes to make up a typographical 
work of art, The Annals is perhaps without an equal in the 
world. But It will have to accept advertising, if it wishes to live 
long. 



62 The Peoria Medical Monthly. 

The you null of the American Medical Association is a finan- 
cial success at any rate. Dr. Davis has accepted the editorship 
for another year. There is still room for improvement in its 
general stvle anc. conduct. As it is now entering on its third 
vear with 4,000 subscribers, it should begin to show up as a rep- 
resentative journal. 



BOOK NOTICES. 
Urinary and Renal Derangements and Calculous Disor- 
ders. Hints on Diagnosis and Treatment. — By Lionel 
S. Beale, M. D. F. R. S. F. R. C. P.; Eng., etc. Cloth, 
pp. 356. Price $1.75. P. Blakiston, Son & Co., Philadel- 
phia, Pa. 1885. 

The author of this tasty volume needs no introduction to 
an American audience. His larger work, "The Use of the Mi- 
croscope in Practical Medicine," is standard, while his Httle 
work, " Slight Ailments," is one of the most practical and useful 
ever written. The work before us is characterized by the same 
directness and lucidity of thought and language that have made 
his productions so valuable. Careful and satisfactory use has 
been made of the microscope in the examination of urinary sed- 
iments and formations. The chapter upon albumen in the urine 
is one of the most important. Contrary to many late writers on 
" Bright's Disease," Dr. Beale thinks physiological albuminuria 
one of the rarest of conditions, and believes its presence to mark 
the beginning of organic disease. The volume is well printed 
and is a credit to its publishers. 

Transactions of the New York State Medical Assoclv- 
tion for the Year 1884. Vol. I. Edited for the Asso- 
ciation. — By Austin Flint, Jr., M. D., New York. 8vo; 
cloth, gilt tops, pp. 654. D. Appleton & Co., New York 
1885. Price $5.00 

This is beyond question the most handsome volume of its 
kind we have ever seen. It is gotten up in the same style as the 
Transactions of the Gynecological Society, and is an a'sthetic ad- 
dition to any library. The contents are fully worthy of their 
setting. The original papers number lifty, and all are of great 
merit. Among prominent names appearing as authors of papers 



Editorial Department. 63 

we note Drs Austin Flint, T. Gaillard Thomas, J. W. S. Gouley, 
J. Lewis Smith, W. T. Lusk, F. S. Dennis, J. P. Gray, C. B. 
Bull, N. Bozeman, E. R. Squibb, E. M. Moore, J. C. Hutchin- 
son and 11. D. Didama, which are suthcient to indicate the char- 
acter of its contents. A not unimportant portion of the contents 
and certainly a very interesting one, is that relating the causes 
which led to the formation of this society, and the manner in 
which it was accomplished. The old code is in good hands yet, 
in New York, and we predict for this society a brilliant future. 

The Oleates, an Investigation into their Nature and 
Action. — By John V. Shoemaker, A. M., M. D. 12 mo., 
cloth, pp. 120, F. A. Davis, atty., Philadelphia, Pa., 1SS5. 
This is a neat little volume containing about all that is 
known on the subject. Most of its contents have already 
appeared in various journals, but it is here collected and 
arranged in permanent form. While not the originator of all of 
the oleates, Dr. Shoemaker has done more than an}^ other one to 
bring them into notice, and he has added to their number and 
proved their value. For this work he deserves great credit, as 
he has certainly added much to our resources for external medi- 
cation. 

PAMPHLETS AND REPRINTS. 

Fifty cases of abdominal section; with remarks on laparo 
tomy, by James D. Hunter, M. D., New York — Reprint from N. 
Y. Medical yotirnal, April 4, 1885. Ovariotomy, by the same — 
Reprint from JV. T. Medical yaiinial, June 7, 1S84. A case of 
psycho-sensory (affective or moral) insanity, by C. H. Hughes, 
M. D., St. Louis, Mo. — Reprint from Alienist and JVenrologist^ 
April, 18S5. Insanit}^ and divorce. The neuropathic conditions 
and treatment- of cancer. Mysomania, by the same. Abstracted 
editorials from the Alienist and JVe urologist, April, 1885. Cata- 
lepsy in a child three years old, by A. Jacobi, M. D., New 
York — Reprint, A/nerican yonrnal of the Medical Sciences, 
April, 1885. Specialties and their relation to the medical pro- 
fession, by L. Duncan Bulkley, M. D., New York — Read 
before the American Academy of Medicine — Reprint, yonr/ial 
of the American Medical Association, December 13, 1884. The 



64 The Peoria Medical Monthly. 

pulley modification of his limiting tenotomy and advancement of 
the rectus muscles with a case, by A. E. Prince, M. D., 
Jacksonville, 111. — 'Repvint, jVezv j'or/v Medical Record. Does 
tobacco produce amblyopia? by W. Franklin Coleman, M. D., 
Baltimore, M. D. — Reprint, Jl/aryhuid Medical "Journal., March 
14, 1S85. Medical jurisprudence in divorce, by Carl H. Von 
Klein, M. D., Dayton, Ohio — Reprint, Jonnial Aiiierical JMcdi- 
cal Association, February 14, 1885. Jewish hygiene and diet, 
the Talmud and various other Jewish writings, hitherto untrans- 
lated; by the same — 'Jotir}ial American Medical Association., 
September 27, 18S4. Treatment of the diseases of the skin by 
novel means and methods, by J. V. Shoemaker, M. D., 
Philadelphia, Pa. The oleates; further investigation into their 
nature and uses b}' the same; extract, from the British Medical 
'Journal., October 14, 1884. Treatment of the insane, by 
Orhens Everts, M. D., 24 pages paper. Practical recommenda- 
tions for the exclusion and prevention of Asiatic cholera in 
North America, b}^ John H. Ranch, M. D., Springfield, 111.; 11 
pages paper. Typhoid fever and low water in wells, by Henry 
B. Baker, M. D., Lansing, Michigan. — Reprint, Report of 
Michigan State Board of Health for 1884. Floating organic 
matter in the air, and its management to prevent disease, and 
to mitigate and control it, with a new device for atmospheric 
purification, with an original illustration, by David Prince, M. D., 
Jacksonville, 111. — Reprint, St. Louis Medical and Surgical 
Journal., February, 1885. 



RECEIPTS. 

The date following each name, indicates where the amount 
credited extends the subscription : 

Illinois — Drs. W M. Dunhip, ( 2.00). May, 1886; W. F. Milieu, 
( 2.00 ), May, 1885; K. V. Jwniing.s, (2.50), May. 1885; E. K. Buard- 
inaii, ( 2.00 j, May, 188(5; F. Driulc, ( 2.n0 ), .May, ]88(), Jno S. Kyburn, 
(2.00 ), May, 1886; Silas Hubhanl, ( 2 00 ), May, 1886; W. A. Thomp- 
son, ( 2.50 ), May, 1886 ; W. II. Coniiibear, ( 2 50 ), May, 1886 ; B. H. 
Harris, (2.50), May, 1886; P. W. Mendeuhall, (2.00), May, 1886; 
A.B. Strong, (2.00), May, 1886; M. F. Bassctt, ( 800), May, 1886; 
W. O. Ensign, ( 2.00 ), May, 1886. 

Iowa — Drs. W. Painter, (2.00), May, 1885; W. McConnauglicy, 
( 2.00 ), July, 1886; Z. E. Funk, ( 5.00 ), May, 1886. 

WiHC'oN.siN — Drs. Fisk & Mallear, ( 1 00 ), Soptcnibor, 1884. 

Nkw Jkkhkv — Dr. L. B. Parscll, May, 1885. 

Ki;ntij(;ky — Dr. II. H. Starks, ( 2.0(i ), May, 1886. 

MiNNEHOTA — Dr. A. VV. Hill, ( 2.50 ), May, 1886. 



Periscope and Abstract. 45 

In closino- the discussion, Dr. Bulkley said that ,he never 
opens a carbuncle, even when it is full of pus, as shown by 
fluctuation. He leaves it to nature to supply a free outlet. He 
thinks that incision leads to absorption of purulent material and 
blood poisoning. — journal Aincrican Medical Association. 



THE TREATMENT OF WHOOPING COUGH. 

The treatment of this disease should be of two characters, 
one of w^hich is addressed to the catarrhal and the other to the 
nervous element. Considering the bacterial nature of the disease, 
antiseptics form one necessary class of agents for treatment. 
Oxygen in the form of an abundance of pure air is always in- 
dicated. The sick-room should be kept at an uniform temper-' 
ature and the air moistened with spray, either of simple ateam 
vapor of lime, of carbolic acid, corrosive sublimate, listerine, 
muriate of ammonia, or cocaine. Th3"mol, eucalyptus or quinine, 
may be used in this form. The. following formulae for use with 
the spra}' are recommended: 

R. 



R. 



Acidi carbolic cryst. 
Sodii bi-boratis 


3 grs. 


Sodii bi-carb. 


aa 20 grs. 


Glyceriupe 
Aquie 


1 oz. 
1 oz. 


Thymol 
Alcoholis 


15 grs. 
3 dr. 


GlycerintB 
Aqua? 


2 oz. 
34 oz. 



(Salve.) 



(Salve.) 

The inhalation of a few drops of ether or chloi'oform is 
recommended when the paroxysms are violent. Of emetics, 
alum is thought to be the best, a quarter or half a teaspoonful 
being given with S3'rup or honey, and repeated if necessary. 
In the mean time the child may be placed upon its stomach, wnth 
the head lowered. Of nervous sedatives, belladonna is the best 
for this trouble, and may be given in suitable doses of the tinc- 
ture, or in the form of the sulphate of atropia, ^\:^ of a grain at 
a time, increased until the pupils are dilated. The bromides of 
sodium, ammonium, or potassium may also be given, and in many 
cases chloral is very useful. Of the latter, for a child one 3'ear 
old, two grains ma}' be given at bed time. Of quinine, a grain 
may be given several times during the day with good effect. 
The foregoing list maj' be increased by the addition of pilocar- 
pine, benzoate of sodium, salic3dic acid, sulphur, cantharides, 
calomel, and soda, etc. Counter-irritation is an important 



46 The Peoria Medical Monthly. 

measure, a mixture of croton oil, oil of amber, and oil of cloves, 
mixed with sweet oil, and rubbed upon the neck or chest, being 
recommended. The bowels should be kept freely open, heat 
applied over the lungs if the}- appear to be implicated, and a 
nourishing diet with a suitable quantit}' of stimulants admin- 
istered. — Arr/iiirs of Pediatrics. 



THE SURGERY OF SCROFULOUS GLANDS. 

In these two clinical lectures, delivered at the Leeds Infirm- 
ary', the author summarizes his experience during the last seven 
years in the operative treatment of these cases. The following 
are his general conclusions: 

1. Our guiding principle should be, that whenever septic 
material is contained in the system, we do not rest until it is 
expelled, and its burrows laid open and disinfected. 

2. In the majorit}' of cases of " scrofulous neck " seen, 
there was no evidence of any constitutional taint or disease. 
The origin of the ailment was clear and defined — as bad drains, 
scarlet fever, mumps, etc. The cases were often isolated in- 
stances in families free from anv tendency to constitutional dis- 
ease. The removal of the condemned glands was very rarely 
followed b}' any further enlargement of glands, or by the need 
of a repetition of the operation. 

3. Surgical interference is not only justifiable, but demand- 
ed: (i) whenever a sinus resulting from a degenerating gland 
exists; (2) whenever pus can be detected in connection with an 
enlarged gland; (3) whenever enlarged glands are accessible in 
a patient in whom a caseous or suppurating gland has been al- 
ready discovered. 

4. The question of removing glands not having suppurated, 
nor having proven caseous in a single instance, yet which are an 
eyesore, or accompanied by lower health, may still be considered 
an open one. Probably in some of these cases cautery puncture 
will be considered the best method of treatment. 

In regard U) tlie surgical treatment, the following principles 
are laid down : 

1. Surgery can bring about in a few weeks the healing of 
gland ca\'ities and sinuses, though of years' duration, and of 
wounds resulting from the removal of caseous and suppurating 
glands. 

2. In dealing with sinuses, gland abscesses, and broken- 
down glands, the treatment must be vigorous and thorougli. 

3. The visible abscess, often called and treated as a stru- 
mous gland, is as a rule, merely a subcutaneous reservoir of pus, 



Periscope and Abstract, 47 

the gland from which it comes being not subciitancotis but sub- 
fascial — sometimes even sub-muscular — the communication be- 
tween the two being often only large enough to admit a small 
probe or director. 

4. It is futile simply to puncture such an abscess without 
removing the gland deeper seated. 

5. When a damaged gland is removed before the over- 
lying skin is thinned by suppuration, the resulting scar is slight. 

6. Where depressed cicatrices resulted, there had been in 
almost every instance, long standing sinuses present. 

7. In dealing with a sinus, the channel should be enlarged 
by a knife or " Bigelow's sinus dilator," and the whole of its 
granulating surface scraped off. When a shallow sinus is 
covered by thin blue skin, this should be rasped away by the 
scraper, and any overhanging cutaneous edges be trimmed off 
with scissors. 

8. In dealinfj with an abscess, the surgeon should in no 
instance rest content until he has discovered and eradicated the 
gland, alwaj'S remembering that if it be not obvious, there is sure 
to be a small track leading through the deep fascia to the 
missing gland; this should be enlarged to admit the spoon of the 
scraper. 

9. When the gland has not suppurated, and is movable, it 
can be removed with very little dissection, almost by enucleation, 
and the resulting scar is insignificent. 

10. When a gland has suppurated, and generally when it 
has become caseous, the capsule should be freely opened and the 
contents eviscerated by Lister's scraper. This is sometimes quite 
ditlicult, the tough lining stump being closely adherent to the 
capsule. This remnant should be dissected away, even at the 
risk of injuring other structures. 

11. Sometimes, after such evisceration, the finger detects 
the bulging wall of a contiguous gland. This should be opened 
and removed through the wall of the cavity. Thus, three or 
four may be removed through one external opening, when in 
close contact and broken down or suppurating. 

12. The cavity, after removal, should be well cleansed b}- 
a carbolic-acid solution (1-40), and then charged with iodoform. 
A rubber drain, reaching to the farthest recess, is fixed to one 
extremity of the wound, the edges of this being carefully brought 
together by fine catgut sutures. The whole is covered by an 
antiseptic absorbent dressing. The tube should be removed in 
a week. It is rarel}' necessar}^ to renew it. Should a further 
drain be necessary one of gilt wire should be inserted, which 
should remain until all is healed except the track of the tube. 



jj.8 The Peoria Medical Monthly. 

Cuts are given of the different scrapers used, the author 
preferring that devised bv Lister, the cup of which is oval, ahnost 
circular, and the handle long and having a double curve. 
Bigelow's " sinus dilator," which works on the principle of an 
ordinarv glove-stretcher, he tinds a valuable instrument in these 
cases. The second lecture is devoted mainh' to illustrative cases. 
— Arc/lives of Pediatrics froui Med. Ti))ies. 



SALICYLATE OF SODA IN RHEUMATISM. 

Prof. Clark treated eleven cases of acute rheumatism — all 
that occured at his ward at Bellevue — with this drug. In nine 
of these cases there was early improvement following the use of 
the medicine. In two cases the amelioration was more gradual. 
The influence of medicine iji " lowering the fever heat and 
diminishing the excited pulse were as marked as its power to 
relieve pain." 

The formula used in all cases is as follows: 

R. Acid salicylic 3 dr. 

Soda l)i-carbonate 2 dr. 

Glycerine 1 oz. 

Aqua ad. 8 oz. M 

Sig. — Tablesiioonful every two hours the first day, and afterward 
the same dose six times a day. 

No unpleasant effect of an}- kind was noticed after the 
administration of the medicine. — Medical Record. 



HYPERTROPHY OF THE TONSILS. 

As a beginning in the treatment of chronicall}' enlarged 
tonsils, if there be no ulceration, at least a portion of the 
redundant tissue should be removed. But if for any reason 
remo^•al by surgical procedure is not allowed, then the following 
will (jften prove useful. As topical sorbefacients, we would 
suggest the following prescrijitions: 

No. I. — R. Hydrate chloral, carbolic acid — pure iodine, 
camphor aa. gr. v., alcohol, one to two ounces. M. Ft. Sol. S. 
Aj)pl\' tfj tonsils with moderate pressure, once every two to four 
days. 

No. 2.--R. Oleate copper, oleate bismuth, balsam pure aa. 
dr. ss., hcjney, on to two ounces. Mix. S. Apply to tonsils 
once or twice a day during the intermediate days of prescription 
No. I. As constitutional remedies, we use something like 
the following prescriptions: 



Periscope and Abstract. 49 

No. 3. — R. Fl. ext. yellow dock, fl. ext. stillingia, s}-!-. 
ipecac an. dr. ii. elix. iodo-bromide calcium comp. qs. ft. oz. ii. 
M. Ft. Sol. S. Half to one teaspoonful (for small children) 
three times a day, just after meals. 

No. 4. — R. Syr. hypophosphite soda (Gardner's is best) 
oz. ii. S. Half to one teaspoonful (for small children) three 
times a day, just after meals, If the patient be decidedly anctmic, 
the following prescription will be useful and pleasant to take: 
R. Cit. iron and manganci^e, gr. xxiv, aqua dest., oz. i., glycer- 
ine qs. ft. oz. ii. M. ft. sol. S. Half to one teapoonful (for small 
children) three times a day, just after meals. 

Of course, these prescriptions, or something similar, should 
be varied as to strength, and frequency of application and 
administration, to suit each case. But whatever drug remedies 
are used, either topical or constitutional, they should be charged 
every week and other appropriate remedies used for the same 
space of time; while in the majority of cases, the patient should 
be allowed to rest entirely from drug treatment one week out of 
every three weeks. This course of treatment should be per- 
sistently carried out until the patient is cured, which usually re- 
quires at least several months. — Dr. J^. C. Smithy M. D. ( Texas 
Courier-Record of Medicine^ 



ACNE ROSACEA. 



Dr. Tom Robinson tlius writes in the British Medical foiir- 
;///'/, January 18, 1S85: 

That alcohol does produce in some skins all the degrees of 
acne rosacea is undoubtedly true; but, to associate all cases of 
the disease with excessive drinking is unscientiffc and unfair. I 
I know very many most rigidly careful people afflicted with the 
malad}-; and the unpopular n;ime for these red spots being "grog 
blossoms," in no wav diminishes their suffering. 

The treatment may be summed up in a few sentences. It 
is essential that all those who are atllicted with acne rosacea 
should abstain from all food which is difficult to digest, such as 
pork, veal, hashes, stews, and uncooked vegetables; and, as a 
general rule, from wine, beer and spirits. The face should not 
be irritated by common soap, and care should be exercised as 
regards exposure to the wind and sun. The meals should be 
slowly eaten at regular hours, and the fluid put into the stomach 
at the end of the meal. 

In the first degree of the disease it will only be necessary to 
prevent the development of the papules, by applying a lotion. 



50 The Peoria INIedical Monthly. 

made with bismuth and the glycerine of starch of the Pharma- 
cofiivia, diminishing the starch by three-fourths. 

When the papules are developed, nothing answers so well 
as a lotion made with two grains of the bisulphuret of mercury 
in one ounce of almond-emulsion of glycerine of starch, used evey 
night. 

When the inflammation is acute, and suppuration is going 
on, we must, in the tirst instance, foment the face with hot water 
(placing a hot sponge over any troublesome spot, is a simple and 
useful plan) ; and, when the acuteness of the inflammation has 
subsided, rub in an ointment made with twenty grains of the yel- 
low oxide of mercury in one ounce of lard, and continue this 
treatment until the inflammatory process has stopped; after' 
which, the bismuth and starch lotions answers well. 

Internally, I always rely upon a mixture made with an alka- 
line carbonate; soda, I think, is best. If there be much inflam- 
matory thickening, I add the solution of perchloride of mercury, 
or if there be an}' S3'philitic tendency to grapple with, I add the 
Donovan's solution; if scrofula, cod-liver oil; but internal and 
external remedies are useless where organization of tissue has 
taken place. I have never seen an operation performed upon 
the advanced cases of acne rosacea. — Med. and Surg. Reporter. 



KAVA KAVA IN CYSTITIS. 

Dr. Dunstone ( Theraf. Gazette^ : A most obstinate case 
of cystitic, of several 3'ears' standing, has recently been under my 
care, and as it presents several points which may be of interest 
to tlic profession, I venture to made the following brief report of 
it. The inflammation seemed to affect the whole urinary tract, 
sometimes being more concentrated in the bladder, and, again, in 
the kidneys. The exciting cause was unquestionabty gravel, for 
at limes concretions as large as a grain of wheat would be passed. 
At such times the pain was, of course, excruciating. Exacerba- 
tions of gout were not infreciuent, and the patient's rest was dis- 
turbed by frequent urination. After exhausting, in vain, all the 
remedies usuall\- empl(jyed in such cases, I was quite discour- 
aged, and began to cast about for something new. T'he flrst 
drug whicii I selected was kava kava, of which 1 gave a tea- 
spoonful of the fluid extract ( P. D. & Co.), in a teacupful of lukJe- 
warm water, morning and evening. The lirst dose caused a pro- 
fuse perspiration and gave entire rehef from pain. The stools, 
also, which had been previously of a clayey apjiearance, assumed 
their normal bilious color. In Umr days the urijie became as 
natural as a child's, and was voided with scarcely a trace of un- 
easiness. The patient was, in addition to the kava kava, kej-)t on 
an exclu.sively milk diet, and went on to complete recovery. 



Periscope and Absoract. 51 

TEETHING OF INFANTS. 

Dr. James Erwin Baker, of Lancaster, Pa., praises cocaine 
for its quieting effect in the peevishness of teething infants, and 
for its value in procuring sleep in such cases not only for the 
baby, but for its parents as well. He writes that he used the 
drug in the case of his own child, who was cutting his tirst teeth, 
and was very restless and irritable. A four per cent, solution 
was rubbed on the mucous membrane firmly by means of ab- 
sorbent cotton. " After two applications, two minutes apart, the 
child ceased screaming, went to sleep within five minutes, and 
slept for three hours uninterruptedly." During the following- 
day two application were made with the result of quieting the 
child almost instantly, and without inducing any bad effects. A 
whitening of the mucous membrane, caused by the capillary con- 
traction, was also observed. Dr. Baker adds that the results 
obtained in this case suggest* the employment of cocaine in the 
diarrhoea due to the reflex irritation from teething, and he pro- 
poses to try it at the earliest opportunity. — Med. Rccoj'd. 



INFLUENCE OF CIMICIFUGA RACEMOSA UPON 
PARTURITION. 

In a paper with the abouve title, read before the Chicago 
Obstetrical Society, Dr. J. Suydam Knox reaches the following 
conclusions : 

1. By the use of the black cohosh the duration of the first 
and second stages of labor is diminished at least one-half. 

2. Cimicifuga has a positive sedative effect upon the par- 
turient womau, quieting reflex irritability, nausea, pruritus, and 
insomnia, so common in the last six weeks of pregnancy; it 
always renders them less distressing, and they often disappear 
under its administration. 

3. Cimcifuga has a positive antispasmotic effect upon the 
parturient woman. The neuralgic cramps and irregular pains 
of the first stage of labor are ameliorated, and often altogether 
abolished. In fact, during the first indiscriminate use of the drug 
in all cases, I had the mortification, with a few women, of ter- 
minating the labor so precipitately, and without prodromic sj^mp- 
toms, as to be unable to reach the bedside before the birth. 

4. Cimicifuga relaxes uterine muscular fibre, and the soft 
parts of the parturient canal, by controlling muscular irritibility, 
thus facilitating labor and diminishing risks of laceration. 

5. Cimicifuga increases the energy and rh3'thm of the pains 
in the second stage of labor. 



52 The Peoria Medical Monthly. 

6. Cimicifuga, like ergot, maintains a better contraction of 
the uterus after delivery. 

His method of administration has been to sfive fifteen minims 
of the fluid extract of cimicifuga in compound syrup of sarsapa- 
rilla each night for four weeks before the expected confinement. 



TREATMENT OF ECZEMA. 

Henry J. Reynolds, M. D., professor of Dermatology in the 
College of Physicians and Surgeons, of Chicago, read a paper at 
the Illinois State Medical Society, of which the following is an 
abstract : 

He said an intelligent knowledge of the principles upon 
which treatment should be based always suggests the form of 
treatment that will be applicable to each case regardless of its 
name or location. The pathological condition being absolutely 
identical in no two cases, so the treatment must always vary, and 
a knowledge of specified lines of treatment or combination of 
druii's said to be useful with a neglect of consideration of the 
principles upon which treatment should be based in each individ- 
ual case, in this, as in all other diseases, is liable to mislead. 
Therapeutically speaking he regards the disease as always either 
acute, sub-acute, or chronic, regardless of its clinical name or lo- 
cation, and arranges the treatment accordingly. 

In the acute, as in all other acute inflammations, the great 
principle necessarily involved, is rest, which implies not only 
quietude of the member part, but rest from all irritating; in- 
Jiiienccs, as scratching, irritation of lice, friction, dirt, incident to 
the calling of the individual, too frequent washing, etc. Sooth- 
ing and protecting measures, therefore, are indicated in this 
stage, among which may be mentioned Carron oil, poultices, etc. 

In the sub-acute, as in all other stages and forms, scratching 
must be strictly prohibited, as it is the most fruitful of all sources 
of aggravation. 

lie uses in this and the chronic conditions (cither of which 
may at any time develop acute symptoms and require tlie treat- 
ment changed accordingly) pure, impalpably line boracic acid as 
a dusting powder; having first gotten rid of crusts and scales by 
soaking with oil and washing with soap and warm water. In 
the chronic, however, he uses greater stimulating measures, in 
the way of green soap frequently rubl^ed in during washing. 
To relieve intense itching he has found nothing so effectual as a 
first class letting alone. 

He thinks l^andaging and strapping advisable whenever 
practicable, and prefers the cotton roller to the rubber where 



Periscope and Abstract. 53 

there is much exudation or maceration of the skin. He reports 
two cases of 12 and 20 years standing respectively, of eczema 
rubrum of the leg associated with varicose veins and ulceration, 
where many remedies have been tried without success, that he 
cured by the application of boracic acid bandaging, and a saline 
laxative internally. 

He says as certain constitutional conditions predispose to 
the disease, and therefore necessarily aggrevate or prolong it 
when once established, the conditions must be sought after and 
be corrected. 

He has but little faith in the popular skin remedy, arsenic, 
in this or in any other disease; all he knows fositivclx of the 
remedy is that you can do harm with it. Chrysarobin, internally 
as recommended by Stocquart, he has tried without any benefit. 



THE TREATMENT OF NIGHT COUGH. 

This troublesome condition, which often precludes sleep, is 
treated of by Dr. A. W. Mac Coy, fn the Medical Ncws^ Febru- 
ary 28, 1885. He thus concludes: 

" It is a well-known fact that a drink given to a child will 
often cause a cessation of the paroxysms, the fluid simply 
pushing down the exciting foreign body. This clinical fact 
gives us the clew to the successful treatment of these trouble- 
some cases. If the nasal passages are thoroughly cleansed 
before the child is put to bed, the night will probably be 
uninterrupted by this irritative cough. If the discharge accum- 
ulates in the nasal passages or upper pharynx -during the night 
and gives rise to a paroxysm, it is simple procedure to cleanse 
the nasal chambers, and at once relieve the S3'mptoms. Treat- 
ment can be most effectively carried out by means of a spray 
composed of an aqueous solution of a alkali. By its use these 
cases need no longer be harrassing to either practitioner or 
patient. — Med. and Surg. Reporter. 



VAGINAL CALCULUS. 



The Codralblatt f. Gynakologie tells of a large vaginal cal- 
culus, size of a goose <t^^,., which was removed by forceps. It 
was formed around a wooden pessary w^iich had been /;/ situ for 
ten years. 



Dr. H.J. Garrigues, in the American yunrna! of Obstetrics, 
reports a case of a lack of vagina, uterus and ovaries in a well- 
formed woman. 



THE 

Peoria Medical Monthly. 



THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher. 
204 S. Jefferson St., Peoria, III, 



***The Editor is not responsible for the statements or opinions of contributors. 

***Short original articles are invited from any reader, whether a subscriber or not. 

***If extra copies are desired by a contributor, the number must be specified when the 
article is sent to the Editor. 

***A11 exchanges, books for review, and communications must be addressed to the Editor 
and Publisher. 

***The publication day of this journal is on or about the 15th of each month. 



EDITORIAL. 

THE PLACEBO QUESTION. 

The Medical Record replies to our comments upon its article 
" the ethics of placebos," tirst by catching us up on a typographi- 
cal error, in which "canonical fractures" should have read 
" canonical practice." 

Secondly, as follows: " Physicians and intelligent laymen 
know that the former cannot always tell the patient the truth 
without injuring him. It should be the rule of his life, however, 
to be straight forward and candid. Therefore, we say that 
placebos should be, and need be rarely, if ever, prescribed." 

We cannot see that the last sentence is the logical sequence 
of the two proceeding ones. 

We must not always tell the truth; we must always be 
candid (tell the truth), therefore., we must never act an untruth. 

This is the way the Record argues, and if it is not casuisti- 
call it is certainly not logical. 

The Record asserts that we feel there is " something in 'The 
Physician Himself,' which it would be wise to hide," and so far 
it agrees with us. 

^^^s, we do feel that there is something in medical practice 
that the public have no business to know. Tiiere are methods 
of treatment instituted for the relief of the patient, that would 



Editorial Department. 55 

certainly be out of place in a daily paper; the publication of 
which would work an injury to the profession. There are 
things in the practice of every honest and honorable physician, 
the public ought not to know ; yet, we see no harm in discussing 
these things in purely medical books. 

The Record in a sense, is public property, for every week 
we see extracts from it in the papers, and we are forced to believe 
that the Record has a list of non-professional exchanges, for that 
reason we said an editorial utterance in the Record that a 
physician "is in duty bound upon certain occasions to tell a lie 
and deceive a patient," is liable to do the profession more harm 
than a statement in a purely professional work as to how best 
prepare an inactive medicine. The Record objects to the " two 
obtrusive worldliness" of Dr. Cathell's book, and quotes the 
maxims of Prof. Gairdner for the guidance of him who would be 
the ideal physician. " He must have a soul above mere money- 
grubbing; must, on no account degrade his profession into a 
trade; but must be, as far as it is possible to human nature, the 
disinterested friend, the companion, the good genius, I had 
almost said, of all of his patients. 

He must be a man endowed with a deep sense of moral 
responsibility so as to beget confidence and unfailing trust in him 
on the part of his fellow-men. 

Responsibility, therefore, to them in the first instance; but 
underlying that, and sustaining it as surely as the root and the 
stem sustains the flower — a deeper and more latent responsibility 
to Him who is the source of all good, and, therefore, of all moral 
principle and moral responsibility whatever." 

True every word of it — of the ideal physician, but who 
has ever reached that plane? In itself, the above quotation is the 
best refutation of the Record''s statement, " the physician is in 
duty bound to tell a lie," that could be offered and we thank our 
honored opponent for it. ' • 



A WORD ABOUT OUR MONTHLY. 

Last month we made some promises, — the appearance of this 
number must decide whether they have been kept or not. For 
our part we think they have, and more, for we have secured a 
finer qualit}^ of paper, and made some other improvements, which 



56 The Peoria Medical Monthly. 

we think warrant us in saying we have one of the handsomest 
Medical Journals published. These improvements cost money, 
but the friends of the Monthly have always been prompt in its 
support in the past, and we feel contident that they will not allow 
their kindly interest to wane now. We have some heavy bills to 
pa}' by June 20th. Are we asking too much if we ask every 
subscriber who owes us anything to pay it now? The money 
due us is already earned, pray do not make us earn it again. 

If you like the new journal we would like to know it. Drop 
us a card and tell us what you think of it. 

The quality of its contents must depend upon its contribu- 
tors, and we hope that the new volume will contain a larger number 
of original articles than we have yet had. We offer you a fine 
setting for your papers, and a wide range of readers. We invite 
every reader to favor us with an article during the year. 



EPIDEMICS. 



The possible invasion of this country by Asiatic cholera du- 
ring the coming summer, has increased the general interest felt in 
epidemic diseases. The medical profession are not yet able to 
determine many questions in relation to them, as to their origin, 
methods of propagation or cure, hence anything treating upon 
this subject is of interest to all. 

We extract some practical hints on the subject of epidemics 
in general, from a very interesting paper read by Dr. Robert 
Roskoten, before the Dickinson Medical Club of this city. 

" An epidemic may originate from general causes, cosmic 
or telluric, as influenza and cerebro-spinal meningitis, or it may 
be propagated from a single individual to others by a contagion, 
as small-pox and scarlet fever, or by infection after the secretions 
of a patient have undergone certain changes, as typhoid fever. 

Some diseases, as yellow fever, sj-)(jntaneous and endemic in 
the beginning, frequently rise to the height of an epidemic, and 
increasing in intensity become strongly contagious. 

Although we understand by an epidemic more a diffei'ence 
in iIk; rmniber of individuals affected by a disease, than a differ- 
ence in the disease itself, it must be remarked: 

1st. That as yet we do not know the percentage which 
justifies us in pronouncing a hitherto sporadic disease epidemic. 

2d. That not all spf)radic disc^ases are ca|')abk' of assuming 
an epidemic character. 



Editorial Dkfartmp.nt. 5.7 

3d. That those diseases hable to become epidemic, in- 
variably show a relationship, a modification of one or the other 
symptoms, and sometimes an increase in force and intensity. 

4th. That there are epidemic diseases for which no 
equivalent can be found among sporadic diseases. 

No chronic affections are known to become epidemic; the 
acute form is the most constant character of all epidemic diseases, 
which fact also explains the velocity of their spreading. 

It is characteristic that every epidemic reflects the picture of 
an affected individual, (provided he recovers) and thus it passed 
through the same stages, namely attack, increase, acme, decline 
and end. 

In the beginning of the plague which devastated Marseilles 
in 1720, death set in so rapidly that none of the characteristic 
signs of the ailment became apparent. **In the year 1800 
Cairo was visited by the plague, and at first nearly every one 
attacked died; but graduall}' the epidemic lost its force, and 
towards the end of the pestilence almost ever}- patient recovered 
in spite of the most opposite methods of treatment. The same 
is true in cholera, which towards its end becomes more manage- 
able." 



A CASE OF PURE GALL. 

C. W. Surdam, M. D., of Providence, R. I., is evidently 
suffering from the most aggravated attack of pure gall ever 
known. 

Our reasons for judging so, are that in the May No. of 
the Mass. Eclectic Aledical yournal, appears an article on " the 
curability of epithelioma" by C. W- Surdam, which, w^ith the ex- 
ception of live introductory lines is identical with an article, 
entitled " the curability of epithelial cancer and kindred ulcers" 
by Dr. Collins, of Ohio, and printed in the Cincinnati Lancet and 
Clinic in 1882. 

The language used is the same, the treatment is the same, 
the number of cases reported is the same, and, strange to sa}-, 
the discription of each particular case is exactly the same. 

With these signs before us we have no hesitancy in pro- 
noucing the case of C. W. Surdam, one of unadulterated gall. 

The article of Dr. Collins is one of considerable interest, 
and a copious extract will be found in the Peoria Medical 
Monthly, Vol. Ill, No. 7, page 286. 



58 The Peoria Medical Monthly. 

AN UNWARRANTED SUSPICION. 

We regret to notice the many slurs that have been written 
b}' medical editors upon the ph3'sicians attending General Grant. 

The weight of public opinion is so strong as to force daily 
information as to the condition of such a patient, and his 
physicians cannot withhold it. Their position is a difficult one, 
but the medical profession should have enough confidence in the 
honesty and ability of such men as Drs. Shrad}' and Barker, to 
feel that they are doing their wholl}^ professional and ethical duty 
under the conditions in which they are placed. 

A hint, that the improvement of General Grant, is due to 
the free administration of potassium iodide, is both ungenerous 
and improbable, 3'et such a hint has appeared in the pages of 
several of our exchano-es. 



HOW TO CURE A FELON. 

An article with the above title has lately appeared in a 
majority of our exchanges. The author Dr. C. C. Gratiot, 
however, did not give credit to the proper source. 

The treatment proposed is taken from this Journal, and may 
be found in Vol. IV., No. i, page 25. The author is Dr. J. M. 
Hole, of Ohio. 

We do not mean that Dr. Gratiot has given the treatment 
as his own; only he failed to credit it to its proper source. 



NOTES AND COMMENTS. 

The ancient joke about the baby, marked C. O. D. is again 
going the rounds of the medical press. Give us something new, 
please. 

Dr. Wm. Brodie has been elected president of the American 
Medical Association. The next place of meeting is St. Louis, 
May, 1886. 

Dr. H. G. Houston, editor of the Athmtk Medical 'Journal, 
Richmond, Va., is dead. He was but thirt}' years of age, and 
had a bright future before him. 



Editorial Department. 59 

Delay in getting our new paper is the cause of this month's 
tardiness in issuing the Monthly. Wonder what will cause us 
trouble next month ? 

Sugar moistened with good cider vinegar is said by Dr. 
Tucker {^Soiithern ]\Iedical Rccord^^ to be a specific for hiccough. 
Give from a few grains to a teaspoonful. 

It is reported that both Jefferson Medical College and the 
University of Penns} Ivania have discontinued their post-graduate 
courses. Polyclinics seem to have won the day. 

Ottawa, Illinois, has a live, new medical society. We hope 
to be able to record the formation of many new societies during 
the coming year, and we would like to have reports from them. 

Dr. J. W. Holland, of Louisville, Ky., has been elected 
Professor of Medical Chemistry in Jefferson Medical College. 
Thus the effete east recruits her forces from the brains of the 
rowdy west. 

Texas sent the largest delegation to New Orleans. Over 
one hundred and twenty were present by actual count. The 
Courier-Record is rapidly infusing new interest in things medical 
in the Lone Star State. 

Since the yournal of the American Medical Association was 
started the increase in membership of the association has in- 
creased from 138 to 281 per annum. Pity the Illinois Medical 
Societ}' did not have a journal or something that would increase 
its membership. 

Dr. Doremus, of New York, has but one arm, yet his in- 
come as an anal3'tical chemist is said to be over $25,000 a year. 
Many men with two arms have hard work to make that, but 
probably Dr. Doremus has more than half a head, where the 
others may be lacking. 

The address of • B. Keith & Co., in their advertisement, 
should read 75 William St., instead of Liberty St., as it appears. 
This firm is one of the oldest and best known pharmaceutical 
manufacturers in the country, and their preparations are equal 
to the best. 



6o Tin<: Pj<:(>«ia Mi:dicai. Monthly. 

We heartily cong-ratulate Dr. W. A. Bj^rd, of Quincy, on 
his election to the presidency of the Illinois State Medical Society. 
The act is a public recognition of his eminent surgical abilities, 
and we predict that he will make one of the best presiding 
officers the society has ever had. 

The officers of the American Medical Editors' Association 
for this year are as follows: President, Dr. H. O. Walker, 
Medical Agx, Detroit, Mich.; Vice-President, Dr. F. L. Sim, 
iMississip^i Valley yJ/^r^/r^'/ J/(9w////v, Memphis, Tenn.; Secretary, 
Dr. F. E. Daniel, Courier-Record of Alcdicine^ Texas. We 
really would like to know what practical value this association 
has ever been to medical journalism. An association of medical 
publishers might accomplish some good. 

The epidemic in Plymouth, Pa., has been decided to be 
typhoid fever. It was due to the contamination of the water in 
the reservoir by the stools of a single t3'phoid patient, whose case 
occurred on the stream suppl3'ing the reservoir, several miles 
from the town. The epidemic has been one of the most disas- 
trous of its kind ever known, but it has also been very instruc- 
tive. The lack of simple hygienic precaution has caused the 
death of nearly one hundred persons, besides the loss of time and 
money of a thousand others. 

"Iowa is the illiterate physician's paradise, no requirement 
being made for the practice of medicine. If a man or woman 
has the gift of gab, lots of cheek, especially is he or she can dress 
well and make a good appearance, they will succeed in making 
a practice. The less education he has, the better. Little or no 
moral character required, either. This is the status of the med- 
ical profession in Iowa." — lozva Slate Medical yoiinial. This 
was the condition of things in Illinois prior to the passage of our 
Medical Practice act in 1877. We are not yet free from quacks 
but their number is constantly decreasing. 

Dr. A. Jacobi, of New York, is having a livel}- correspond- 
ence with Dr. J. W Shoemaker, of Philadelphia, in relation to 
the statement made at New Orleans by Dr. S. " that new code 
men made threats at Copenhagen that if they were not recog- 
nized they would use their influence to j^revent the International 



The Peoria 
MEDICAL MONTHLY. 



Vol. VI. : : JUNE : 1885 : : No. 11. 



ORIGINAL COMMUNICATIONS. 
ADDRESS ON SURGERY. 

BY WM. A. BYRD, M. D., QUINCY, ILL. 

Report of the Chairman of the Surgical Coruniittee, Illinois State Medical Society, and read 
before that Society May 19th, 1885. 

In presenting the report on surgery I shall pay but a pass- 
ing tribute to the literature of surgeiy and anatomy of the past 
year, but must call the attention of the Society to the superb 
plates and text of Dalton on the Topographical Anatomy of the 
Brain, Treves' work on Intestinal Obstruction, and the book of 
Hugh Owen Thomas, of Liverpool, upon Intestinal Disease and 
Obstruction, a work that I think should not only be read but 
carefully studied by every man practicing general medicine and 
surgery. Perhaps the majority of the profession would not agree 
with the author, but there are few indeed who would not learn 
much of value. The International Encyclopedia of Surgery has 
progressed slowly but very satisfactorily. Reeves on Deformity 
will be of real advantage to the general practioner and prove of 
value to many orthopedic surgeons. 

The little work of John B. Roberts on Surgical Delusions 
and Follies is worthy of careful reading. 

VanBuren's Principles of Surgery has much to commend it. 
Pye Smith's Surgical Handicraft is also valuable. Then we 
have revised editions, not in name only, of Hamilton's Fractures 



66 The Peoria Medical Monthly. 

and Dislocations, and Bryant and Erichsen's systematic works 
on surgery. 

Taking up special subjects, the extirpation of the thyroid 
gland was being, carried on to a considerable extent in Europe 
of late years, but Kocher published a paper upon the subject of 
thyrodectomy, in 1883, in which he brought forward the evil 
effects resultant upon the system. This paper caused many ex- 
periments to be made upon animals to settle the disputed points. 
Zesas was one of the most careful of the experimenters, and he 
found that thyrodectomy in animals was soon followed by a gen- 
eral morbid condition. Among the signs may be mentioned 
somnolency, unsteady gait, and other muscular and nervous dif- 
ficulties, and from these experiments he holds that thyrodectomy 
is an unjustifiable operation since the regulation of the cerebral 
circulation is one of the physical functions of the body. Be that 
as it may, I have only removed the thyroid gland once, three or 
four years ago, from a lovely child about four years of age; she 
did well for a few months and then dwindled and died. Whether 
this was from the effects resulting from the loss of the gland I 
am unable to state. The value of such a work as Dalton's Topo- 
graphical Anatomy of the Brain is made apparent when we see 
Drs. Lee and Fenger, of Chicago, opening an abscess of that 
organ, and Mr. Rickman J. Goodlee, of London, upon the advice 
of Dr. Hughes Bennett, cut down upon a glioma the size of a 
a walnut and removed it. 

Operative procedures for the cure of epilepsy and insanity 
are becoming more common and I believe more successful. The 
failure, in some instances, in effecting a cure being, perhaps, due 
to not removing enough of the irritating bone, as suggested by 
Dr. W. T. Briggs, of Nashville. The hope for the future of 
surgery of the brain was never brighter. 

Abdominal surgery is still advancing. 

Dr. Wm. T. Bull, of New York, cuts down upon injured 
intestine from a pistol wound, resects the injured portions, unites 
the ends, and the patient makes a happy recovery. Dr. Andrews, 
of Chicago, happily having two cases, on neither of which he 
operated, of gunshot wound of the abdomen with injury of the 
intestine, in one case the stomach was empty and in the other it 
was full of beer, (tliis leaves us in the sad predicament of not 



Original Communications. 67 

knowing whether total abstenence is better or not if one is going 
to be shot in the abdomen.) Both cases were treated with per- 
fect rest and with opiates, and both recovered, Dr. Joseph 
Grindon, of St. Louis, also reports a case of stab of the abdomen 
inflicting wounds upon the intestine, recovering after two inches 
of the intestine is resected, the ends of the bowel united and 
dropped in the abdomen. But these are enough cases of this 
sort to give a general insight into the progress being made in 
the treatment of wounds of the intestine. 

Several cholecystomies have been successfully made during 
the year, among them, one by Dr. Chas. T. Parks, of Chicago, 
and one case of gall stones seen b}^ Dr. R. G. Bogue, of the same 
city, unoperated upon, the fost-inor'teni revealed facts of interest 
in showing that the method of exploring the gall bladder with an 
aspirator needle (as first practiced by Drs. Whittaker and Ran- 
sohoff), would have been futile as there were six gall stones the 
size of a filbert, impacted in the common duct, and they would 
have remained undiscovered. In such cases exploratory incision 
is the only method that offers hope. In such a case, removal of 
the stones and stitching together of the edges of the wound 
would have been about the only thing that could have been done, 
yet I must believe that in any opening made in the gall bladder 
for stone, the edges should be stitched to the abdominal wound 
so as to permit a free external flow of the bile, to prevent a re- 
currence of their formation while the patient is treated for the 
relief of the catarrhal condition of the bile ducts so common in 
such cases. The practice of stitching the edges of the opening 
in the gall bladder together and returning to the abdomen ma}^ 
be done successful!}' as evidenced by a case operated upon not 
long since by Dr. A. C. Bernays, of St. Louis. 

I must not forget the ingenious proposition of Dr. J. M. Gas- 
ton, of Atlanta, Georgia, to make a fistulous communication be- 
tween the gall bladder and intestine, thus allowing the bile to 
flow into the intestine and perform its functions. Even if there 
is closure of the mouth of the common duct, the bile can flow 
around through the cystic duct and bladder into the intestine. 
But that the bile is not absolutely essential for life is proven by 
the case reported to the Mississippi Valley Medical Society last 
fall, in this city by Dr. F. W. Beard, of Vincennes, Ind., of a 



68 The Peoria Medical Monthly. 

patient of his that had survived for years with the bile flowing 
from a fistula he had formed with his scalpel. 

All surgeons admit that amputation at the hip joint is one 
of the most formidable that they are called upon to perform. 
Not alone from the extensive surface laid bare and the shock, 
but from haemorrhage and the evils resulting from the means em- 
ployed to control the haemorrhage. When the abdominal tourni- 
quet is employed the intestine may be so bruised as to cause en- 
teritis, perforation, peritonitis and death. 

Davys' lever, even in his own hands, has so wounded the 
bowel as to cause death, while introduction of the entire hand 
into the rectum frequently causes laceration of the colon. To 
obviate this, Lloyd, of Manchester, adopted the method of pass- 
ing a stout india rubber tube around the hip, allowing the ends 
to cross above Poupart's ligament. Under the point of crossing 
a compress was placed so as to bear on the artery above the lig- 
ament. The ends of the tube were then entrusted to assistants. 
This method was tried successfully by Dr. Wheaton of St. Paul. 
The objection to it is that it is tiresome to the assistants, and 
brings more persons than are necessary around the operating 
table to be in the way of the operator. The latter objection ap- 
plies equally to some of the methods mentioned above. To ob- 
viate these evil effects I have devised the method of applying a 
figure of eight of ^ inch French elastic tubing around the effected 
hip and opposite side of the body. Where the tubing passes in 
front to go under the perineum of the affected side, it should 
come on the front side of the anterior process of the ilium, and 
go below the process when it crosses the body on the opposite 
side. Then to keep the transverse portion from rising and 
slacking over the lax tissues of the abdomen, tie a piece of band- 
age around the tube about the middle of the back and bring it 
forward over the perineum and tie down the front part of the 
tube. Then apply a three-inch, tightly rolled bandage two inches 
thick over the course of the iliac artery where the rubber crosses, 
and with heavy thread or twine stitch it to the V formed by the 
rubber. Retract the portion of the elastic band behind the 
affected limb with a piece of bandage passed around it and tied 
to the back cross-rubber, drawing it tightly. This is done to 
prevent it slipping off when the limb is raised or amputated. I 



Original Communications. . 69 

have tried this method twice within the last year, and know of 
nothing that could be more satisfactory. 

In one case, September 29th, 1884, near Hannibal, Mo., I 
amputated at the hip joint for osteosarcoma of the femur. The 
patient was a large man and had had the femur amputated at the 
lower third for sarcoma of the knee over a year before. The' 
disease had returned and was giving him great pain. As a last 
hope and for the relief of his suffering I amputated at the hip 
joint, controlling the hemorrhage as indicated above. Of course 
there was a good deal of blood in the limb. After the amputa- 
tion there was not over six or eight ounces of blood upon the 
floor and in the vessel that was used to catch it. The vessels 
were twisted and he was in bed in fifty minutes from the time 
he was taken from it to the table. 

The other case was one where the man sustained a com- 
pound fracture of the femur from falling from the top of a moving 
railroad car to the bottom of a ravine, the distance being about 
thirty feet. This was April 4th, 1885. The shock was so great 
that he was not fit for amputation until the 8th, by which time 
there were symptoms of acute osteomyelitis. Amputation was 
performed as above, and he died the morning of the 12th, not 
from the amputation of the limb, but from phlegmonous inflam- 
mation in the other limb, which had been greatly bruised, caus- 
ing septic trouble. The patient did well for two days after the 
amputation, and it seemed as though he would surely recover 
until the swelling commenced in the other limb. The vessels 
were twisted. I did not apply an Esmarch's bandage before 
making this amputation, as I did not wish to drive any of the decay- 
ing material in the limb into the circulation. There was a good 
deal of ichorous inflltration in spite of free drainage which had 
been established through the lower portion of the wound with 
rubber drainage tubes. The limb was elevated to allow the 
blood to flow back into the body before applying the turniquet . 
There was some blood escaped from the vessels of the ampu- 
tated limb, but with that exception I do not think there was half 
an ounce of blood lost. By this method the hemorrhage is not 
only controlled from the femoral, but also from the gluteal and 
obturator arteries. 

I have purposely mentioned that I twisted the vessels be- 
cause I am firmly convinced that it is a much safer method of 



70 . The Peoria Medical Monthly. 

treatment than the ligature when applied to large vessels. I 
twisted these femora as they emerged from under Poupart's lig- 
ament, and would have been perfectly satisfied to have twisted 
the common iliac or aorta should any possibility have required 
it. If a ligature is applied to an atheromatous artery, the vessel 
will most likely give way, and there will be secondary hemorr- 
hage. Vessels in such condition should be treated by some one 
of the methods of acupressure. How long should a vessel be 
twisted ? Until the elasticitv of its coats give way. Take a 
leather tube, which is inelastic, and bend it in a twist sharply 
upon itself once and try to force water through it, and you will 
find that it will burst above the twist before the twist will give 
way. The artery, when rendered inelastic, will obey the same 
invariable physical law. What instruments are necessary to 
perform torsion or twisting satisfactorily ? One good solid 
jawed pair of forceps that will not wabble during the pressure of 
the operation, such as the Golding Bird slide-catch forceps, or the 
Prince or Lawson Tait ring handled pressure forceps. The ob- 
jection to using two forceps is that the vessel is apt to be torn 
across to some extent near the jaw of the forceps that holds it 
crosswise. I have not ligated an artery of any size for nearly 
five years, and do not think I ever shall if my results continue as 
good as they have been in the past. 

There is one operation where twisting is especially indi- 
cated, and that is castration. The whole cord should be caught 
up in the jaws of a stout pair of forceps and cut off nearly an 
inch from the same. B}' this means the hemorrhage is con- 
trolled, and the vessels will protrude from the cut end of the cord 
most satisfactorily, so that they may be picked up leisurely and 
twisted. In this instance the cross forceps do no harm, since the 
vessels are surrounded by a mass of tissue that prevents them 
tearing across at the corners. The cord is dropped and there is 
no fear of the agonizing pain, or even tetanus that sometimes 
follows the catching up of some filament of nerve in the grasp of 
the ligature. There will not be the long waiting for the liga- 
tures to come away, sometimes having to be coaxed away with 
little elastic bands fastened to the limbs with sticking plaster. 

Some years ago, not many, I read a translation from the 
German, by Dr. Nicholas vSenn, where the surgeon (1 have for- 



Original Communications. 71 

gotten his name) recommended the opening of psoas abscess in 
the groin and passing a probe or sound along the sinus until above 
the ilium, and there making another opening down to the sound, 
thus shortening the passage way of the pus and rendering recov- 
ery more rapid and certain. 

Mr. Frederick Treves, of London, recommends and has 
practiced, cutting down directly upon the diseased vertebrae, but 
limits the operation to diseased lumbar vertebrae. I think the 
operation can be very readily and safely extended to caries of 
the dorsal vertebrae, resecting if necessary a portion of the rib 
or ribs near the vertebral column. From the time I read Dr. 
Senn's translation I concluded the operation not only feasible 
but rational, and intended putting it in practice when proper 
cases presented. April loth, 1885, a man aged about thirty 
presented at Blessing Hospital. Had Potts' disease involving 
the four lower dorsal vertebras, with a resulting psoas ab- 
scess pointing under Poupart's ligament, nearly ready to burst. 
He was put under the influence of an anaesthetic and the abscess 
opened at its most dependent point. A solid tin probe, the size 
of an American gauge No. 15 catheter, was passed up the sinus 
until its point was under the edge of the twelfth rib: It was 
then cut down upon, a drainage tube attached to it, and the probe 
withdrawn, carrying with it the drainage tube, which was left in 
the sinus, a length of fifteen inches. The sinus was washed out 
twice a day with a strong solution of boracic acid. In four days 
after the operation he returned to his home at Mendon, 111., and 
most of the time since he has been engaged at his business, keep- 
ing a peanut stand. His family physician, Dr. L. F. Brown, re- 
ports that, in his opinion, he improved so rapidly that within two 
weeks of the operation he removed the drainage tube, finding 
pieces of bone sticking in its openings. Since the removal of the 
tube several pieces of bone, some half as large as the little finger 
nail, have escaped from the wound, principally the .upper one. If 
the upper opening should close too soon, and he again presents 
for treatment, I shall enlarge the upper opening and take out a 
portion of the ninth and tenth ribs near the vertebrge so as to get 
perfectly at the diseased structures. I should have done so at 
first but hoped for sufficient drainage from the proximity of the 
upper opening to allow all the detritus to escape. If I do not 



72 The Peoria Medical Monthly. 

cure him I will have the satisfaction of having prolonged his life 
with less suffering and given him his only chance for recovery. 
Now, gentlemen, I have tried to give you a mere sketch of 
a few things in which I think surgery is progressing. Had I 
gone into greater detail you would have been so wearied with 
the reading as to regret greatly that you had put me on a com- 
mittee to report upon surgery. 



I 



CONJUNCTIVITIS WITH COPIOUS PURULENT DIS- 
CHARGE. 

BY P. W. MENDENHALL, M. D., GEORGETOWN, ILL. 

On the morning of the last day of April, a little more than 
one year ago, the writer of this article discovered on arising that 
the conjunctiva of his right eye was inflamed, being intensely red 
and considerably swollen. The pain, which was still very slight, 
was of a smarting, burning, character, and there was rather a 
free purulent discharge whenever the lids were separated. The 
day previous I had driven eight or nine miles facing a strong, 
cool wind, and as I had not, to my knowledge, been exposed to 
any source of contagion, I at once concluded that the conjuncti- 
vitis was of the catarrhal form. During the day all of the above 
symptoms rapidly increased in severity, so that by evening the 
thickness of the lids was considerably increased and the purulent 
discharge had become so copious as to require almost constant 
attention to keep the eye open. There was by this time also 
considerable discharge from my nose, with sneezing and other ca- 
tarrhal symptoms, the inflammation having apparently traversed 
the lachrymal duct and invaded Schniderian membrane. 

Due care was taken that the eye should not be inoculated by 
having the discharges carried to it. Notwithstanding my pre- 
cautions to prevent it, the disease made its appearance in the 
inner canthus of my left eye on the following morning, having 
apparently reached it by extending up the lachrymal duct. By 
noon of the second day it had spread over the whole conjunctival 
surface of the second eye. 

Both eyes were now about equally affected, and the pain 
was so much increased that I could obtain very little sleep at 



Original Communications 73 

night. The swelling of the conjunctivag was so great that the 
cornea of each eye appeared to be set back from the front of the 
ball, the inflammation, redness and thickening terminating ab- 
ruptly at the corneal margin. 

Photophobia was well marked, though not so severe as to 
be in proportion with the other symptoms. The purulent dis- 
charge, which was the most characteristic symptom, was so 
abundant as to require nearly all my time to keep it from entirely 
obscuring my vision. I tried the experiment and it took scarcely 
five minutes for it to agglutinate the lids together so that I was 
unable to open them without the aid of my hands. 

I now come to the treatment, which is the most important 
part of this article, and as it involves that which to me is a new 
idea, it may not prove uninteresting to others. I had taken a 
special course in diseases of the eye and ear while at college, so 
that I felt perfectly confident of my ability to treat my case in- 
telligently. 

I first commenced bathing my eyes frequently in very warm 
water, which gave considerable relief to the pain and insured 
cleanliness ; at the same time using a mild solution of the sul- 
phate of zinc, say 2 or 3 grs. to the ounce of distilled water. 
Afterwards I added morphia sulphate. This not appearing to 
affect the condition of my eyes favorably, to the next zinc mix- 
ture I added aluminia sul. and atropia. Afterwards lost con- 
fidence in the zinc and changed to a collyrium composed of tan- 
nin and distilled water, to no better effect. 

I next consulted my friend Dr. P., who told me to take some 
salts to cool my blood. I did this, but without making any favor- 
able change in the condition of my eyes. I then consulted my 
friend Dr. C, who advised me to take calomel to reduce the 
inflammation. This I did with no better effect. The warm, or 
rather hot water baths still gave me more relief than any other 
application that I had tried. About one week of my trouble had 
now passed and I had nearly come to my wits end, and began to 
despair of a very early and rapid recovery. 

I had still attended a few patients in and near town, wearing 
glasses and a sun shade when out of doors. One da}- when vis- 
iting a patient, an old lady who happened to be visiting at the 
house said to me, " I can tell what is the matter with your eyes. 



74 The Peoria Medical Monthly. 

your have erysipelas in them. I had it in mine once." Thanks 
to the old ladies, they are usually good women, but often not very 
good doctors ; still we often profit by their suggestions, as I did 
in this case. 

On returning home I took internally gtt. xl of tr ferri mu- 
riat., which I repeated in four hours. After the second dose the 
change for the better was so marked and sudden as to leave no 
doubt of the cause of the improvement. I still continued the 
warm water baths and the sulphate of zinc collyrium. After 
about the fourth dose of iron, I had exhausted the small supply 
I had on hand, and my eyes were so much improved that I 
thought they would recover without using more. In about 
twent3'-four hours the improvement had not only ceased, but all 
the symptoms began to increase, when I again resumed the iron 
and again was gratified with a prompt improvement which went 
on to a rapid and complete recovery. 

Case 2. A. H., a miller by occupation, came to my office 
January 15th, this year, to consult me on account of a soreness 
that had suddenly affected one of his eyes. I found the same 
characteristic redness, thickening of the conjunctiva, and puru- 
lent discharge as described in my own case, in one of his eyes, 
which by the next day had spread to the other. I gave him tr 
ferri in large doses, also a mild zinc collyrium. I advised him 
to bathe his eyes often with warm water, and wear glasses when- 
ever he was out doors in the wind. The result was just as 
happy in this case as in my own, for on the fourth day there was 
only a little redness left, which soon disappeared and complete 
recovery followed. If tincture of iron is, then, so valuable in 
erysipelas, why might it not prove to be valuable in almost all 
cases of conjunctivitis, acting as a tonic astringent, contracting 
the capillaries, and removing the hyperemia "^ It certainly will 
in those cases that occur in debilitated constitutions and in puru- 
lent conjunctivitis. 



Cholera is said to be prevalent in about twenty cities and 
villages in two provinces of Spain. This much leaks out in spite 
of the anxious endeavors of the government to suppress all in- 
formation concerning the ravages of the pestik'nce. — Louisville 
Med. JVews. 



Original Communications. 75 

INFANTILE MENSTRUATION. 

BY E. NEWTON CAMPBEI.L, M. D., GOOD HOPE, ILL. 

Was called to attend Mrs. A., aged 26, in her third confine- 
ment, April 15th, 1885. She had passed through a normal pe- 
riod of gestation, and after an ordinary labor was delivered of a 
well-matured female child weighing eight pounds. When the 
infant had undergone the usual ordeal of washing and dressing, 
I observed it to have rather a peculiar manner of breathing, be- 
ing that of a superficial and sighing character. Upon examina- 
tion I was unable to discover any organic malformation of either 
heart or lungs. The child was warm, of a good color, and the 
circulation free. But I found the heart action markedly slow, 
beating about forty-five times in the minute, yet strong and reg- 
ular. After about twenty-four hours colic took possession of 
the little innocent, and from that time on until it was five days 
old seemed to suffer more or less pain in and about its bowels, 
the character of which did not simulate the pain and distress of 
a pure and unvarnished colic. 

On the third day it had a mild convulsion, and during the 
fourth day another convulsion of a severe type which came near 
snuffing the last spark of life that was diml}^ manifest. It was 
with difficulty that the child was resuscitated from this second 
attack, but by careful and constant work, such as cold to the 
head and hot water to the feet, friction of soft flannel, the 
little one pulled through. By this time it had become very weak 
and prostrated, with a disposition to faint away into a stupor. 
Proportionate doses of dilute whisky was administered and the 
child placed to the breast at regular intervals. On the fifth day 
it began to menstruate, the blood flow continuing for five days, 
and presenting all the characteristics pecuhar to a menstrual dis- 
charge. As soon as the flow began the child became more 
tranquil, and appeared to grow gradually more free from pain 
and distress. The breathing soon became more natural, and 
from this time on the • pulse rate increased in frequency until it 
was four weeks old, by which time the heart action had attained 
the normal standard for an infant of that age. At this time of 
writing (June 3d, 1885), there has been no return of the men- 



76 The Peoria Medical Monthly. 

strual flux. It nurses its mother, is growing nicely and doing 
well, presenting no precocious appearances, and has the promise 
of an auspicious future. 



PLEADING FOR THE WOMAN IN TRAVAIL. 

BY H. S. BELL, M.D., PARIS, ILL. 
Read before the ^sculapian Society of the Wabash Valley at Areola, 111 , May 13th. 1885. 

The phj'^sician, in the discharge of his merciful mission finds 
opportunity, more frequently at the bedside of the parturiant 
woman, for the ministration of this highest function. 

Where else does he so often witness pain, the intensity and 
duration of which is comparable to that of that of the woman in 
travail d'' enfant f We might now pertinently ask what is the 
rule of action regarding these agonizing pains ? With too many 
of us, the course of nature is the goddess we so blindly follow. 
When the helpless and confiding woman appeals in pitying ac- 
cents to the doctor of her choice for help, for relief, for but a few 
hours rest, she, alas! is too often disappointed and frequently 
lapses into a condition of utter helplessness by being told that 
nature must have its course. The fact is, in such instances, 
whether she realizes it or not, she is left to her own resources as 
much as though she were unattended by her physician. Indeed, 
let me ask of what use is the physician to his patient, if he pro- 
poses to allow nature to deliver her of her child ? It may be 
said that he is to reassure her, to encourage and inspire her with 
the prospect of a speedy and safe delivery. This is all very well, 
gentlemen, with some phlegmatic folks, but there are many wo- 
men, you may call them nervous, nervo-sanguine or what not, 
who become perfectly panic-stricken during the agony of child- 
birth, and who cannot be pacified by the art of fine promises. I 
have seen many of this class, both old and young, almost lose 
reason from the very intensity of pain, and for whom I have in 
vain exhausted a fine vocabulary of comforting phrases. I crave 
your patience for twenty minutes, while I endeavor to advise a 
somewhat different course for the management of labor, from 
that which I believe is pursued by a majority of physicians. I 
am truly conscious of the unpopular position this advocacy of 



Original Communications. 77 

mercy to the parturiant woman places me, but with that consci- 
entious enthusiasm born of minorities, I shall boldly proclaim my 
convictions. The burden of my paper will be in advocating the 
use of chloroform in labor, and the more frequent resort to the 
obstetrical forceps. When called to a case of obstetrics I always 
provide myself with these agents, /. e. morphia, chloroform and 
a pair of obstetrical forceps. 

If I find my patient is much annoyed with ineffectual pains, 
it is my habit to administer from ^ to ^ grain of morphia 
combined with a corresponding proportion of atropia subcuta- 
neously. I expect this to relieve the harrassing pains of the first 
stage of labor, give the patient some sleep, and produce insensi- 
ble relaxation and dilation of the os uteri. This it will always do, 
and will save the doctor several hours of impatient waiting. He 
may either go to bed himself, or, if in town, may go to his home 
or office, with the direction to call him when pains again become 
hard. Now, this is a safe, simple and easy way of disposing of 
the first stage of labor ; that stage which so sorely perplexes the 
physician, and demoralizes the patient. Why seek any further 
for therapeutics to relax a rigid os ? This management of an 
unyielding os is a question full of solicitation to all practitioners. 
Many things are advised for this state of affairs. Dilation with 
the index finger hooked in the os is advised by some; others 
recommend unguentum belladonna in contact with the os. Chlo- 
ral, gelsemium and opium, given internally, are urged. Chloro- 
form by inhalation is advised by a few. Chloroform will act 
happily in this condition, but I think morphia preferable on ac- 
count of the convenience of its administration. It is true that, 
perhaps, the greater number of cases do not require any inter- 
ference from the physician. The dilation is either complete 
when the doctor arrives, or is proceeding satisfactorily. Mor- 
phia is advised only w^hen pains are severe and complete without 
corresponding progress in dilation. 

By the way, on the night of April 13th, last, after having 
attended a woman and delivering her of twins, upon returning 
home at 2 a. m., and while undressing, I received a Call to attend 
another woman in child-birth. Of course I was "tired now and 
sleepy too," but having promised the woman previously to attend 
her, I choked down my wrath and went to attend the second 



78 The Peoria Medical Monthly. 

call. Before reaching- the house I heard the quite audible groans 
of the patient. Upon entering the room I was gratified to see the 
woman in the height of a powerful pain and bearing down with 
all her might, and that, too, of two line large women who each 
had a hand of the patient and pulling desperatel3\ The happy 
and welcome thought occurred to me that the patient would not 
detain me long. Imagine my surprise to find the os not larger 
than a nickel. The woman being a multipara, I rebuked her for 
bearing down, and making such a fuss in the first stage of labor. 
She replied that she could not help bearing down. I told her 
that in my judgment she was liable to rupture her womb in such 
frantic attempts to expel the child through an undilated os. I 
gave her a half grain of morphia with atropia and left with the 
information that I would return after breakfast and dehver her. 
This was about 2 130 a. m. While breakfasting, at 8 a. m., the 
husband came to my house to tell me that his wife slept more or 
less for three hours after my visit, but was now in a great deal 
of miser}^ I at once repaired to the house of the patient ; found 
the same women pulling away at my patient's arms. One of 
these neighbor women, a stranger to me, very pertly expressed 
the opinion that I would allow the woman to die, and that she 
could not approve my giving the morphine and leaving the pa- 
tient for my home. I made little reply, telling her, however, that 
I knew my business probably better than she understood it. 
Upon examining patient, found the head of child pressing upon 
perineum. After waiting thirty minutes, I advised forceps, simply 
to conclude the labor and save patient any further effort. I ap- 
pHed Sawyer's short forceps, and in less time than it takes to 
write it delivered the woman safely of a fine child. 

However, when the dilation of the os is going on well, or 
has already become fully dilated, it is my custom to administer 
chloroform, provided the patient appears to suffer very consid- 
erable pain. Some women seem to go through the various 
stages of labor with but little apparent pain, and in these cases 
I never think of using chloroform. But such stoical women are 
not the rule in obstetric practice. Bearing children is a physio- 
logical process sometimes, but with our strain of women it is 
more often in the border land, between a physiological and a 
pathological process. It is physiological for the stomach to 



Original Communications. 79 

digest food, but does it always do it ? What are the various 
digestive ferments or peptones given for, exxept to assist a natural 
process. It is physiological for the rectum to extrude its feacal 
contents at least once in every tv^xnty-four hours. Does it per- 
form well its function ? The hundred thousand pills and elixirs 
in the market answers nav! 

I could, with a little labor, go on ad infinitum recalling func- 
tional disorders for which we all seek earnestly to relieve. The 
analogy here may turn in another direction, resulting in convic- 
tion to the candid mind. Let me ask what it is the doctor first 
attempts, when at the bedside of a case of cramp colic? In fact, 
what class of medicines first suggest themselves when minister- 
ing to a patient in pain from whatever cause, save the poor woman 
in the hour of her greatest extremity? You all with one accord 
agree that anodynes must always be given to a patient with acute 
pain, and after the pain is controlled such other medicines as are 
indicated may be given. Just why this discrimination is made 
at the expense of helpless women in child-birth I cannot see any- 
just reason. In chloform we possess an agent both certain to 
give an immeasurable relief, and absolutely safe, and free from 
any complication. The chloroform anaesthesia should be carried 
to that degree which changes the behavior of the patient from a 
restless and insubordinate condition to a calm and refreshing- 
repose. I ahvays administer the chloroform in the interval be- 
tween the pains. I remember hearing a professor of obstetrics, 
in a huge diploma factory, say that it was his custom to drop a 
few drop upon a handkerchief and give it, in the hand of the pa- 
tient, while having a pain. This plan I followed until it dawned 
upon me that a woman while having expulsive pains does not 
breathe at all. I pour ten, fifteen or twenty drops upon a hand- 
kerchief, and hold it myself, if I am not too much engaged other- 
wise, in this event I give it in charge of the nurse or neighbor 
woman. The sleep should not be profound, a gentle lull from 
which the patient arouses considerably when each succeeding 
pain comes on. The patient will often complain that 3^ou do not 
give her more. It is somewhat amusing to hear them ask for 
"more chloroform," when just before its inhalation they were 
fearful that its use would be disastrous. 

It is as true of this use of chloroform, as it is of many other 



8o The Peoria Medical Monthly. 

things — it must be tried to be appreciated. As I have said be- 
fore, I never sug-gest chloroform to a woman who is going on 
well; but when thev appear to me to suffer be3^ound a fair tol- 
erance, or become wretchedl}^ demoralized, as manifested by 
screaming, crying, kicking or striking, I not only suggest its use 
but enforce it as I do other suggestions of great consequence^ 
Where I have not previously attended the woman in child-birth, 
I verv frequently encounter a little hesitation on the part of the 
patient, and considerable protest from the old women present. 
However, it is the patient's desires I solely consult, and pay no 
attention to a neighbor woman, unless she is a near relative, 
when I explain its great utility and freedom from evil conse- 
quences. I have rarely failed, even when I found the most stub- 
born opposition, to convert the patient, her sisters, and her cous- 
ins, and her aunts; in fact, the entire household. Recall one 
or more of your obstetric experiences where, from the bad mor- 
als of your patient, pandemonium itself would be an agreeable 
change. Suppose, now, a few whiffs of chloroform were given 
between between pains, see the restful change that would steal 
over doctor, patient and friends. Gentlemen, this is no fancy or 
immaginative sketch, but one copied from real life, and the im- 
proved mental and physical state should alone strongly recom- 
mend it to you. 

The time to use the forceps is quite an arbitrary matter, and 
therefore it is difficult to formulate definite rules. There are 
of course certain indications imperatively demanding their use, 
such as convulsions, excessive hemorrhage, marked exhaustion^ 
and impaction of the child's head. But I find cases where none 
of these alarming conditions are present, which in my judgment 
require their use. I always desire to use the forceps in all 
tedious cases of labor. Many women are almost worn out by 
the time the head is well engaged in the bony pelvis, and to these 
the completion of the labor by the forceps is a godsend. 

I regard the forceps as being in keeping with the times in 
which we live. The prmitive plov\^ has given place to the ad- 
mirable implement upon which we may sit and operate in the 
field with ahnost the same luxuriant ease that we may recline in 
a Pullman coach. A woman may, with the aid of a machine, do 
in a single hour the work which formerly required a whole 



Original Communications. 8i 

week. I need not use time in reminding you of the changes 
which have so incomprehensively taken place in our social and 
industrial life. Nor need I go into elaborate argument to deduce 
from the radical changes above cited, that we as a race have also 
changed, that amindst the excitement in which we live, we have 
lost the insensibility to pain and savage endurance of our fore- 
fathers. 

Therefore, gentlemen, we must realize that the sphere in 
which we move is a progressive one, and that the very air we 
breathe is full of instinct and suggestions. Read on page 344 in 
the excellent treatise on obstetrics by Playfair, how the Princess 
Charlotte of Wales was allowed to slowly perish in child-birth 
by a trio of court physicians, and this, too, at the very time some, 
I might say many of our mothers were in travail with us, the 
members of this society. Many times have I been told by women 
they had in previous labors been in active- childbirth for three 
or four days. However it is to the more frequent use of chloroform 
and the forceps that we owe our present great immunity from 
these saddest of all sad calamities, exhaustion and death shortly- 
following the penalty of maternity. But it is not to insist on the 
use of forceps in these graver cases, that I write; but to urge 
the more frequent use of them in cases of moderate severity- and 
duration. In fact to save the patient needless pain, and the doc- 
tor a waste of time. Now while I have said so much in behalf 
of woman, I hold that after all there something due to the doctor. 
And the physician who does his duty to his patient will also have 
served himself well. What thing is more trying to a doctor than 
to sit by the bedside of a parturient woman, who labors hard and 
impatiently from hour to hour? 

The useless detention of the physician is not only exhausting 
to his muscle and nerve, but it is oftentimes hard on his bank 
account. But a few days ago, I was called nine miles distant to 
see a labor case. I reached the patient by rail at 3 a.m. The 
next and only train for the day, went at 7 a.m. I found the os 
completely dilated, with head entering pelvic brim. This woman 
was already the mother of ten children. I found her screaming 
and throwing herself from side to side of the bed, and wheeling 
upon her back and planting her feet upon the wall of her room. 
I at once administered chloroform, and in a few minutes the halo 



"82 The Peoria Medical Monthly. 

of relief which settled down on the faces of those who were in 
attendance, was such as to make us inaudibly thank God for this 
matchless aid in the lying-in room. By 6 a.m. the child was not 
yet born, and in fact it was doubtful to my mind if she was mak- 
ing any progress. In order to get off on the train I succeeded 
after considerable strateg}'^, in obtaining permission to apply the 
forceps. In a few minutes I delivered the child, and busied my- 
self in the remaing hour with removing the afterbirth and cleans- 
ing the woman. I caught the train, and when near my office I 
observed a messenger hastily dismount and try my office door. 
I soon learned that a man in the country had a few hours before 
broken his leg and desired my services. Moral — Never spend 
too much time with a patient. I again congratulated myself on 
being in time. 

SPINA BIFIDA. 

BY J. P. WALKER, M. D., MASON CITY, ILL. 

The history, semeology, diagnosis, prognosis and pathology 
of this deformity have been sufficiently elaborated; but as to 
treatment I find nothing on which we may rely with any degree 
of confidence. 

Because of this fact, I should like to see every case, success- 
fully managed or not, reported; that we may be able to estimate 
the merits of every variety of treatment and management adopted 
by the profession, and thus be guided intelligently in the man- 
agement of future cases. I therefore report my last two cases : 

I was called, June 22, 1883, to see a babe of Mr. G. W., of 
Logan countv, in consultation with Dr. Davis, of New Holland. 
Found a strong healthy child with a tumor over the lumbar 
region, about five centimeters in diameter, of a dark leaden hue, 
denuded of skin, surface granular, containing fluid. The slight- 
est pressure brought on spasmodic action. 

We covered the tumor with a fine piece of Swiss muslin, 
saturated with carbolized castor oil i part and collodion 3 parts, 
over this the lightest possible covering of absorbent cotten, then 
a heavy coating of the oil and collodion. This dressing ordered 
reapplied every third day. A thick bed of cotton batting about 
the tumor, back and hips — to be changed often — completed the 
treatment. 



Original Communications. 83, 

The walls of this tumor were so thin, weak and ulcerated, 
that we thought it unsafe to aspirate, as I feared that the tinest 
puncture would cause a general rupture of the sack. 

This case seemed to progress favorably for about twenty 
days, when Dr. D. thought all danger of rupture had passed, 
therefore he did not reapply dressing. On the twenty-fifth day the 
doctor was called, and found the patient in strong epileptic con- 
vulsions, which were soon collapse and death. He found the 
sack ruptured and nothing left but the coverings. 

In this case a complete fissure of the fourth and fifth lumbar 
vertebrce existed. The tumor had a very large base^ it could not 
have been called a pedicle. Several spinal nerves were spread 
over the inner walls of the tumor. 

2. I was called, January 5, 1884, to see babe of C. P., aged 
24 hours. Found a well developed child with slight talipes; 
with a tumor of immense size on back of the neck, reaching 
from middle of shoulders to crown of the head. A dispute had 
arisen between the attending physician. Dr. C. P. Crane, of this 
city, and the grandmother as to size of tumor; the doctor con- 
tending that it was as large as the child's head, she maintaining 
that was not so large. They appointed me umpire in the dis- 
pute. On actual measurement I found that the head was the 
larger by one-fourth inch, but if the pedicle had been allowed 
the doctor would have gained his case. I therefore decided that 
both were right and declared the "bets off." 

The tumor was almost globular in form, with a pedicle 4)^ 
inches in circumference, arising as we supposed from a fissure of 
the atlas, axis and first cervical vertebrfe ; but as sHght pressure or 
manipulation caused spasmodic symptoms we could not make a 
perfect diagnosis. The tumor was covered with skin greatly 
attenuated and over its whole surface a few hairs were widely 
scattered. ' 

We adopted the plan as in case i, with a ligature of elastic 
around the pedicle, and aspirating as much fluid as we thought 
could be born every alternate day. We at once applied the hg- 
ature, and with a hypodermic needle drew off two ounces of 
straw-colored alkaline fluid, and as soon as muscular twitching 
occurred the needle was withdrawn. We then covered the 



84 The Peoria Medical Monthly. 

tumor with the Swiss muslin, carbolized oil. collodion and cotton, 
as in case i. 

This treatment was continued, drawing the elastic ligature 
more tirmly every day, and aspirating an increased amount of 
fluid each alternate day. On the ninth day we drew away, as 
we believe, one or two drachms of fluid more than we should have 
done, convulsions supervening within an hour after the dressing. 

They sent for us, but we did not go to see it that da}' as we 
believed the end had come, as is usual in such cases. We pre- 
scribed calomel gr. ]^ every hour. The eclampsia soon passed 
over, and from this time on the progress of the case was as good 
as we could wish. The babe grew as fast as is usual. 

The treatment was continued w'ithout intermission until 
every sign of fluctuation had subsided, and until we were satis- 
fied that the connection between the tumor and the spinal tract 
and brain had been closed. On the first day of April, 1884, we 
pronounced the case cured, as the openings through the bones 
were perfectly closed with callous ligamentous, or osseous, 
deposits or growth, and in the same month I reported the case 
as cured to the Brainard District Medical Societ3^ 

All that remained of this monstrous tumor was a '■^biinch^'' 
as the parents termed it, about the size of the half of a lemon, 
constituted of the superabundant skin and tissues of the walls of 
the sack. 

The decrease in bulk of the tumor from first to last was 
constantly, nearly equal to the amount of fluid taken. 

We account for the occurrence of convulsions on the ninth 
day, because we took away too much fluid, and the pressure not 
being perfect because of the thickened and wrinkled state of the 
walls of the tumor. The parents were very urgent for us to 
remove the '■'■ Jmnch^^'' as it really did look ugly; but we persisted 
that it would be much safer to allow it to remain until first den- 
tition was completed, especially as the '■'■ Imnch'''' was decreasing 
by contraction and absorption, constantly, which if left alone, 
would not need removal even when the proper time arrived to do 
the operation, as we were of the opinion that nature never gave 
too much skin in any case. 

But some time in the fall of 1884, some tnmi of Peoria, who 
ad\ertises, got wind of the case, and through some mutual 



Original Communications 85 

acquaintance of his and the parents " -worked up " or steered the 
case into his hands, and induced them to take the babe to Peoria 
and have this harmless '•'•hunch'''' of skin burned off!!! So this 
7nan got ffty dollars for a fifty cent job; beside torturing a babe 
for nothing. 

SILVER DOLLAR IN THE CESOPHAGUS: EXTRAC- 
TION. 

BY HENRY C. HOLTON, M. D., ARCHIE, ILL. 

On the morning of Ma}- 24, at 10:30 o'clock, Henry Rob- 
ison, a 3'oung man 24 years of age, came to ni}' office to have a 
silver dollar, which he had swallowed one-half hour previously, 
removed from his throat. 

The accident occurred while plaving with a little child. He 
was lying on his back and had the coin in his mouth, or rather 
between his lips, when the child reached for it, but instead of 
grasping it, she accidentalh^ struck it w^ith her hand and knocked 
it into his throat. The coin got beyond his control before he 
could stop it. I made several efforts to reach it with a pair of 
forceps about eight inches in length, but failed. 

At this time Dr. Odbert, of Indianola, called on me and was 
invited to examine the case. He had a pair of forceps about 
two inches longer than mine, at his office. We repaired to Indian- 
ola at once, and his forceps were introduced, but to no avail. 
Dr. Odbert and I then drove to Danville to try to get proper 
instruments for its removal. Failing to find them there, we im- 
mediately dispatched to Philadelphia for forceps, and in due time 
they arrived. In the meantime Mr. Robison was kept on a liquid 
diet. 

On the evening of the second day of June we operated. 
Dr. O. introduced an oesophageal bougie into his throat for the 
purpose of locating the coin, which he succeeded in doing at a 
distance of nine and one-half inches from the front teeth in upper 
jaw, or at the oesophageal opening of diaphragm. I then intro- 
duced a pair of forceps and succeeded in grasping and withdraw- 
ing the dollar from his throat. This is the onl}^ successful oper- 
ation in my knowledge where so large a foreign body has been 
extracted from the oesophagus, so low down. 

Thinking perhaps this case may be of interest to the many 
readers of vour valuable journal, I respectfulh' submit it. 



86 The Peoria Medical Monthly. 

CORRESPONDENCE. 

New York Letter — Studies of IMedical Men. 

New York, April 15, 1885. 

Dear Doctor : In a former communication I ventured the 
opinion that the prominent men in our profession, whatever may- 
be the tenure of their position, are legitimate subjects for study, 
and in that frame of mind indulged in a reference to some of the 
personal characteristics and professional peculiarities of several 
leading gynecologists of this city. Allow me now to attempt a 
completion of the group by essaying pen-pictures of approxi- 
mate accuracy, of others here whose claims to eminence have a 
more or less secure hold upon the estimation of the body pro- 
fessional. These men study each other; why may not we study 
them and their methods. 

In continuation of my theme and its illustrative characters, 
the first name which suggests itself to me is that of Dr. W. Gill 
Wylie, of the New York Polyclinic Medical School. Dr. Wylie 
is a man whose position is sufficiently prominent to warrant its 
occupant's claim to professional consideration. He is a man of 
medium height or more, of stout build, full, round head inclined 
to baldness, closely cut brown hair slightly tinged with gray. 
Smoothly shaven, with the exception of a light moustache, per- 
haps forty years of age or upwards, and has a pleasifig, expres- 
sive face, the mobility of features constituting it a pretty accurate 
index of its owner's thoughts and feelings. 

Dr. Wylie was a pupil of, and for many years the tirst 
assistant to, the renowned J. Marion Sims. The latter infused 
into his pupil many of his own peculiar traits and methods, and 
left him as well fitted as any one upon whom the mantel of his 
master might worthily fall. 

The peculiar state of affairs which drove Sims from the 
Woman's Hospital prevented Wylie from becoming a member 
of its staff. Aside from the position which he holds as prosessor 
of diseases of women in the Polyclinic, he is gynecologist to the 
Belle vue Hospital, and is on the consulting staff of St. Elizabeth 
Hospital. 

Dr. Wylie is a very agreeable and efficient instructor, and is 
popular with medical meru Without the preslii(c offered by a 



Correspondence. 87 

lucrative position on the staff of some such institution as the 
Woman's Hospital, he has by indomitable will and perseverance 
worked himself up to an enviable position of professional worth 
and influence, and a handsome — we might sa}^ larg-e — pecuniary- 
income. 

Dr. Wylie's work, in private, hospital and dispensary practice, 
is characterized by full deliberation in thought and action. Noth- 
ing is allowed to be done hastily. Schooled to caution by the 
vicisitudes of early professional struggles, he carries the trait yet 
into his every day work, and with the most pronounced results. 
Entering upon duty at the Bellevue Hospital at a time when its 
unsanitary condition was most pronounced, and an abdominal 
section within its grounds meant almost certain death to the 
patient, he caused it to be scoured, renovated and disinfected 
from foundation to roof, until he has been able to see already 
twenty-one continuous recoveries from abdominal section on its 
premises. Dr. Wylie examines his patients calmly and dehber- 
ately, and when he arrives at a diagnosis it is most likely to be 
the correct one. In fact, he really approaches more nearly my 
ideal of that happy combination of tact, energy, earnestness, 
honesty, gentleness and technical ability which go to make up 
the genuine physician or surgeon, than any other man I have 
ever met. As an operator Dr. Wylie gives much attention to 
details. He is one of the most successful, if not the most suc- 
cessful laparotomists in this city or country. He wants his 
patient thoroughly etherized. He operates under complete 
antiseptic precautions, using the carbolic spray over patient, 
assistants, instruments and appliances, thouroughly regulates the 
temperature of the apartment, and washes the abdomen and 
instruments with solution of bi-chloride of mercury, i to 2,000. 
He believes in the advisability of as small an incision as is com- 
patible with the object to be accomplished, and is careful to avoid 
any introduction of blood into the abdorninal ca.vity, by giving 
time for all hemorrhage to cease before opening the peritoneum. 
While engaged in exploration he is cai-eful to keep the aperture 
closed as much as possible by the constant application of a flat 
sponge in the hands of an assistant. He closes the abdominal 
wound with silk sutures, exercising great caution in attaining 
exact coaptation of the severed margin.s of peritoneum, muscle 



SS The Peoria Medical Monthly. 

and skin. He is ^-erv ready to use the drainao-e tube when 
adhesions are found, or when an ascitic condition has previously 
existed. 

Dr. Wylie is always up to the times in observation and prac- 
tice and is markedly original in his methods. He has little faith 
in the etlicacy of pessaries of an}- kind for misplacements of the 
uterus, and seldom' uses or recommends them. His idea is that 
such conditions as are usually treated by the application of pes- 
saries are dependent upon causes removable by various other 
means, or else so viciousl}- potent as to circumvent any sort of 
mechanical contrivance. 

The Doctor's original method of treating endometritis by 
the application of cauterants through his uterine speculum has 
been ver}- successful in his hands, as well as in those of others. 
His contributions to medical literature have been comparatively 
few and confined to the periodicals of the day. Although a man 
of rather quiet habits, Dr. Wylie is socially courteous, genial and 
hospitable, and calculated to rapidly extend the circle of his 
admirers. 

Another man of considerable importance here in the ranks 
of gynecology is Dr. Charles Carroll Lee, of the Woman's Hos- 
pital. He is a stout built man of over medium height, of, I 
should think, forty-five j^ears of age or upwards, full, broad face, 
and closely cropped full beard, with moustache. His brown hair 
and whiskers are tinged with gray, and he presents a fine ap- 
pearance physically. He is graceful and courteous in movement 
and manner, and conforms to the requirements of a gentleman 
of the old school. He is said to be somewhat antiquated in his 
.notions, and prefers clinging to old and tried plans and methods 
rather than to venture on others whose claims are not fully and 
well established. Dr. Lee is a smooth and easy talker, very 
deliberate and concise in his diagnositic and operative methods, 
and a man in whom a spirit of conservatism seems to be the rul- 
ing passion. He is a careful and successful practitioner, and is a 
man whose counsels have much weight amongst his associates. 
He is consulting surgeon to Charity Hospital; physician to the 
New York Foundling Asylum, and has been connected with the 
Woman's Hospital for ?<■ long time, a confrere of Thomas, Em- 
met, Hunter, et al. 



Correspondence. 89 

I am led here to remark upon the peculiar advantage con- 
nected with the holding of a position as surgeon to the Woman's 
Hospital. Aside from the clinical advantages as m other hos- 
pitals, only in greater abundance, the associations professionally 
and with the public are of such an influential character as to be 
of very material benefit, in ever}' sense of the word. The rep- 
utation of the institution abroad is such as to bring it under the 
personal inspection of visiting members of the profession from all 
parts of the countr}-, amongst whom influential acquaintances are 
readily formed. Thus many patients are secured, whose finan- 
cial and social standing are such as to not onl}- secure handsome, 
fees for services rendered, but the patronage of others equally 
dessrable, as private patients, etc. In fact, simply the presence 
of one's name in connection with the staff of an institution whose 
reputation is so widespread, is of great advertising advantage^ 
In view of these, strenuous efforts are continually made on the 
part of many ambitious aspirants, for admission. Like all other 
positions of a lucrative character, however, those of the above 
institution are tenaciously in the grasp of a favored few, and are 
said to be dealt out to adherants in accordance with rules and 
regulations of a somewhat ambiguous character. 

Another very prominent worker in this special line is Dr. 
James B. Hunter, a colleague of Drs. Wylie and Munde on the 
professorial staff of the Polyclinic. Dr. Hunter is a man of rather 
spare build, above medium height, of nervous temperament,, 
thin, smooth face with exception of light moustache; retreating 
chin and forehead, light hair, and livelv facial expression. He is 
a person whom one will readily remember after having once seen 
him. He is one of the surgeon's to the Woman's Hospital, and 
is a warm personal friend of Dr. T. G. Thomas, whose appoint- 
ments as lecturer at the College of Physican's and Surgeons he 
frequently fills. As above remarked. Dr. Hunter is one of the 
mstructors in gynecology at the Polyclinic. As a lecturer he is. 
pleasant in manner and speech, but indulges so much in repeti- 
tion as to make it rather tiresome at times to listen to him. Un- 
like Dr. Wylie, he is a great pessary advocate, and uses one or 
other of the thousand and one forms of that much-abused instru- 
ment on every possible occasion. As an operator he is speed}'' 
and successful, but in this as in his diagnostic methods, is so 



90 The Peoria Medical Monthly, 

quick in his movements and unmethodical, so to speak, in his 
manner, as to give one the impression of uncertainty as to 
results. Dr. Hunter looks to be about fortv-five years of age, 
perhaps not so old; is a pleasant and courteous gentleman, has 
contributed some valuable articles to the literature of his profes- 
sion, and as he is a hard worker, would seem to have a bright 
prospect before him for pryfessional preferment. 

A man in the gynecological ranks here well-known to the 
profession through his frequent contributions to current medical 
literature, is Dr. Henry J. Garrigues. He is obstetric surgeon 
to the New York Maternity Hospital, and physician to the 
gynecological department of the German Dispensary of the City 
of New York. He is a German, foreign born, of medium stat- 
ure, very spare in build, thin face, with light, sand}' hair, mous- 
tache and goatee. Dr. G. is of nervous temperament, very 
active in his movements, and although pleasant and courteous to 
those about him, is very easily irritated. He is fulh' aware of 
the fact that his foreign birth has militated considerably against 
his success, in excluding him from institutional privileges which 
would otherwise have been of eas}- access to one of his ability 
and professional acquirements. One of the results of Dr. Gar- 
rigues' energ}' and devotion is the great reduction in mortality 
amongst the h'ing-in at Maternitv. The latter, be it understood, 
is simply the obstetric department of Charity Hospital, and fur- 
nishes abundant material for observation and experiment. The 
mortality in this department was fearful. The unsanitary condi- 
tion of the building, the close proximity of the surgical and other 
wards, and the wretched social condition of those applying for 
care, conspired to render it a perfect hot-bed of death-dealing 
puerperal troubles. Dr. G. resorted to ^'arious means without 
notable success, until a year or two ago, when he adopted a plan 
of the most complete isolation of each patient during and imme- 
diately subsequent to delivery. They are carried to a room in 
one of the pavilions (frame) in the yard, all communication with 
other rooms or patients cut off, and the apartment whitewashed 
with lime and made bare of everything but the absolute necessi- 
ties. Immediately after delivery of child and secundines the 
uterus and vagina are syringed out with sol. of bi-chloride of 
mercury, and the vulva covered with a dressing made after the 



Correspondence. 91 

following description in the Doctor's own words, which I take 
from his article in The Med. Record of Dec. 29, 1883: "Con- 
sisting (i) of a piece of Hnt, six by eight inches, folded length- 
wise, so as to be three inches wide; (2) outside of that a piece 
of oiled muslin, nine by four inches; (3) outside of that a large 
pad of oakum; and (4) the whole is fastened with four pins to 
the binder in front, and behind by means of a piece of muslin 
eighteen inches square, and folded diagonally so as to form a kind 
of boat, five inches in width, for the reception of the other pieces 
of the dressing." The above is changed four times in twenty- 
four hours, and each time before applying the genitals are 
washed with the bi-chloride solution. In private practice the 
Doctor adopts now the same method, except that he substitutes 
absorbent cotton for the oakum. As to the effect of this treat- 
ment the Doctor says : " The change in the condition of the 
patients and the wards before and after its adoption has been so 
sudden and surprising as to convince everybod}" who knew the 
institution before." 

In conversation with Dr. Garrignues on the above subject a 
few days ago he told me that he had concluded, from the experi- 
ence of others, that it was safer to use the bi-chloride in the 
strength of i to 2,000 than i to 1,000, as recommended in the 
Record article above referred to. 

Dr. G. is fond of the microscope, and makes much use of 
it. He is pretty well up in years now, perhaps as much as fifty, 
and for the past year has been in quite ill health, although now 
very materially better. He has a very comfortable private prac- 
tice, especially amongst his own countrymen, or rather women, 
and if the improvement in his health should prove permanent he 
bids fair for a vast increase in business and usefulness. 

But, Dear Doctor, I must bring this gossipy letter to a 

close. Very truly, 

O. B. Will, M. D. 



Haeckel gives a description of a new substance, called by 
him " dundakinka," obtained from the bark of the sarco- 
cephalus esculenta growing in Senegal. It is a bitter resinoid 
substance, soluble in water and alcohol, possessing astringent 
and antipyretic properties, and has been proposed as a succed- 
aneum of quinine,— J/cc/. Record^ May 9, 1885. 



g2 The Peoria Medical Monthly. 

PERISCOPE AND ABSTRACT. 
BUTTERMILK IN SICK STOMACH. 

An irritable stomach, it will be admitted, is often a most 
serious complication in the management of sickness. In occa- 
sional cases, of no particular gravity otherwise, oftenest in diseases 
of children, this difficult)- leads to a fatal issue. Buttermilk, so 
far as I am aware, is an untried remedy in such cases. I have 
had some experience recently with it, quite satisfactor}- in a few 
instances. Four cases of persistent vomiting occurred in suc- 
cession, intolerent of any other treatment, gave way kindlv to 
this. 

Case I, was that of a child about two years old. The vom- 
iting was accompanied by other sickness. The child had not 
retained anything, fluid or solid, for two days; the food being 
almost immediately ejected. I suggested buttermilk in teaspoon- 
ful quantities, every ten, then every five, minutes, the milk to be 
quite cold and as fresh as possible. The vomiting did not recur, 
and in two days the child had changed from a condition of 
impending death, from collapse, to nearly its normal condition. 
In place of teaspoonful quantities, the stomach soon sustained 
larger ones, and so on till an ordinary quantity could be taken. 

Case II, was that of a nursing child suffering from a mild 
derangement of the digestive process, accompanied by fever and 
persistent vomiting while anything remained in the stomach. 
The mother's milk was immediately rejected. I again ordered 
buttermilk, in the same manner as before, much to the surprise 
of the parents. Next da}^ the father reported that there had 
been no vomiting from the time this treatment commenced. 

Cass III. — This was an adult female. Three weeks before 
she had been confined, and at this time was suffering from a mild 
attack of peritonitis, with constipation and nevous troubles. 
There was constant nausea in this case, even when the stomach 
was empty — a feature in which it differed from the other three. 
Buttermilk was cooled with ice, and carefull}- given in gradually 
increasing quantities till it was retained quite well, after other 
remedies had all failed, and in twelve hours it could be taken 
freely. The nausea was overcome with more difficulty in this 
ca.se than in the others. 

Case IV, was that of a child one year old and weaned. The 
mother »had been away from home some distance with the child, 
visiting. While absent, a slight diarrhoL-a occurred, iiccompanied 
by sick stomach. When I saw it the stomach difliculty predom- 
inated greatly. Everything given was immediately expelled 
with force. The mildest remedies were not retained a moment. 
The stomach was intensely sour, and food taken therein days 



Periscope and Abstract. 93 

before was passed from the bowels undigested. Buttermilk, as 
directed in the other cases, was ordered, with lime-water. The 
vomiting subsided very quickly, and the stomach could soon tol- 
erate boiled milk thickened with flour. This change became 
necessary on account of the condition of the bowels, which now 
became as intolerant of the buttermilk as the stomach had been, 
the milk passing through immediately after ingestion. After the 
change of food no passage occurred for twenty-four hours. 

Four successful cases will, of course not establish the value 
of any remedy, but the recital of them may lead to further trial. 

So far as I have observed, buttermilk does not coagulate in 
the stomach, as does new milk. This is perhaps its only advant- 
age over the latter, but one of inestimable value, since the coag- 
ulation of new milk casein, so likely to occur, utterly forbids its 
use in many cases. In the "summer complaints " of children, 
for instance, buttermilk might be found eminently appropriate. — 
Therapeutic Gazette. 



TREATMENT OF BROMIDROSIS OF THE FEET. 

Few affections of the skin are more disgusting or more dif- 
ficult to treat successfully, by the ordinary methods, than foetid 
sweating of the feet, with or without excessive secretion. The 
thickened skin over the heel and anterior ends of the metatarsal 
bones seems to afford a very secure and ineradicable nidus for 
the as yet undifferentiated enzyme which induces fermentaiion 
with its foetid products there. One form of treatment seems to 
be invariably successful, and, therefore, deserves to be much bet- 
ter known, Viz., that devised by Hebra, which, he says, never 
fails, and recommends to be used in all severe cases. Hebra 
employed the following ointment: 

R^ Olei lini, 

Emplastri plumbi liquefacti, equales partes. 
M Ft ung. 

This is directed to be spread thickly over a piece of linen 
large enough to cover the sole and sides of each foot; both feet, 
in the first place, to be carefully washed and dried. Pieces of 
linen rag, well covered with the ointment, he directed to be 
placed between the toes, so as effectually to separate them and 
secure thorough application of the ointment. Over this the sock 
or stocking could be worn with a light, new slipper, and the 
patient allowed to pursue his or her ordinary calling. This 
dressing is to be repeated every twelve hours for ten or twelve 
days. The foot not to be wetted after treatment has begun, but 
wiped when necessary with a dry cloth, or washed with dry bran 



94 The Peoria Medical Monthly. 

or other mealy substance should any part become dirty or caked 
with old ointment, etc. 

Whether mild or severe, all cases are curable by it, and no 
other method seems to yield such a prompt and satisfactory 
result. To insure success, the whole of the skin of soles and 
sides of feet and toes must be tanned by the process, and grad- 
ually thrown off as brown leathery exfoliation in from two 
to four weeks. All boots, sho'es, slippers, etc., worn by 
the patient should be discarded, because if worn again, the 
patient is reinfected in three or four months, and gradually be- 
comes as bad as at first. Stockings or socks should be very care- 
fullv cleansed, and disinfected by heat or by steeping in a hot 
solution of perchloride of mercury (i in i,ooo of water) for 
several hours before being washed. Neuman directs that 
Hebra's ointment and dressing should be changed once in three 
days for nine days, — that is, three times altogether, — a method 
not to be relied on in man}' cases seen in this country. What 
Mr. J. S. Stewart {Edinbtirgh Med. Joiirn., March, 1885,) has 
found to yield the most satisfactory result, in treating a tolerably 
lonu; series of cases, is to have the feet thorou^rhlv washed in hot 
water, then steeped for a few minutes in a solution of perman- 
ganate of potash, of the strength of from four to six grains in 
the ounce of water. The feet are then dried, not to be again 
wetted until complete exfoliation of the tanned cuticle has taken 
place. 

Hebra's lead-plaster ointment is then thickly spread on strips 
of cloth about one and a half inch broad, and the foot covered 
from the toes back over the heel as hicjh as the inalleoli with 
these, arranged and applied like a scultetus bandage. Each toe 
should first be wrapped round with a strip of clean rag half an 
inch broad and thickly spread with the ointment. This dressing 
should be renewed every twelve hours with fresh rags and oint- 
ment for a period varying from ten to sixteen days, according to 
the .severity of the case and the thickness of the heel skin. In 
most cases the odor will be very much diminished by the end of 
the third day, and will not be perceptible by the ninth. The 
shedding of the skin takes place jyari passu with the growth of 
the new cuticle, and may not be completed until the end of the 
third or even of the fourth week. — Therapeutic Gazette. 



RAPID ANESTHESIA I5Y ETHER. 

The following method of rapid anaesthesia by ether was 
suggested to Dr. A. F. Miiller seven or eight years ago by the 
thought that the great length of time often consumed in etheriz- 



Periscope and Abstract. 95 

ing patients was due to the fact of the frequent interruptions 
necessary to replenish the cone or towel used for the purpose, 
and the consequent partial recover}^ of the patient. To obviate 
the difficulty and obtain a continuous flow of pure ether vapor, 
he had made an apparatus, consisting of the two valves of a rub- 
ber foot-ball, sewed together at the edges and connected by a 
tube with a bottle containing ether, which is plunged into a bucket 
of hot water. Ether boils at 98 "^ F., and vapor passes over 
steadily and rapidly, and is inhaled by the patient, v/hose face is 
covered by the inhaler, protected by a clean towel. 

The result has been surprising, as seen in his report of 
eighteen cases, all etherized by this method within the last three 
months at the Germantown Hospital, Philadelphia. In none of 
the cases was there nausea previous to ansesthesia; one at least 
came to the house the morning of the operation having eaten a 
hearty breakfast. In most cases no struggling, and if so, only 
slight; no stage of excitement. In cases that require only a few 
moments for operation, the patient wakes up nearly as quickly as 
after nitrous oxide. After the patient is etherized, the amount 
passing over can be regulated by a stock at the bottle end of the 
tube. 

The average time in producing unconsciousness in the 
eighteen cases reparted was seventy-four seconds. — Medical 
JVezus. 



PECULIAR FORM OF FIBROUS TUMOR WHICH 
TENDS TO MULTIPLICITY AND INDEFINITE 
GROWTH. 

There is a kind of fibro-cellular tumor which runs rather a 
peculiar course and is occasionally multiple. In most of its feat- 
ures it appears to be quite innocent; that is, it does not infiltrate 
adjacent structures, and is usually encapsuled. Its multiplicity 
would, however, suggest that it is possibly infective ; and it does 
occasionally ulcerate and fungate. 

The two best examples of this form of new growth that are 
in my mind occurred in ladies in early middle life. 

Mrs. P , of Darlington, died after amputation at the hip 

for an enormous tumor of this kind. It had been growin<x for 
more than ten years. It had developed deeply in the right thigh, 
but did not adhere either to bone or skin. It had at first lifted 
the femoral vessels forward, but, I believe, eventually it wrapped 
around them. 

I had seen Mrs. P. repeatedlv at long intervals, during six 
years previous to her death, and once had a consultation with Sir 
James Paget on her case. When I first saw her the tumor was 



96 The Peoria Medical Monthly. 

so large and so deeply placed that it would have been impossible 
to attempt its extirpation without being prepared to amputate at 
the hip joint. She was in feeble health, but still quite able to 
discharge all her domestic duties : she had a large, young family. 
and the prolongation of her life was of the utmost importance. 
After much consideration, I advised not to have an operation, 
believing that the immediate risk of one was more than it was 
worth her while to encounter, and being influenced also by the 
fact that she had other tumors. One such had been excised from 
her back recently in Leeds, and was reported to be of a fibrous 
nature, and near its scar there was another about as large as a 
plum. It seemed to me not unlikely that even if Mrs. P. sur- 
vived the excision, or possibly an amputation at the hip joint, 
these tumors might take to growing, or that others might de- 
velop. I am inclined to think that my advice was justified by 
the sequel. Although greatly incommoded by the enormous size 
and weight of the tumor of the thigh, Mrs. P. lived for five 
years after I first saw her, and during that time was able to dis- 
charge all her social duties. At length becoming quite incapac- 
itated by the mere bulk of the growth, and confined to her bed, 
amputation seemed the only resource. It was performed, with 

every precaution and skill by Mr. T , of Leeds, but she sank 

within a few hours after it. 

I doubt much whether the operation could have been done 
earlier with any better result. It is, of course, possible that the 
tumor might be enucleated; but so deeply did it extend that I do 
not think that such an operation would have been less dangerous 
than amputation. 

The tumor was a firm lobulated mass; as stated, it never 
adhered to the skin, and I believe it never caused any material 
pain. 

The tumor which I have mentioned as present in Mrs. P.'s 
back, had not, I believe, grown materiall}^, and she had none 
other. It is very possible that had the primary one been re- 
moved its activity of growth might have been transferred to this 
smaller and more quiet one. There was never any gland affected 
by the disease. 

It is to be noted that while this primary thigh tumor began 
deeply under the femoral vessel the two others were subcutane- 
ous. In my next the same peculiarity was present, but the order 
was inverted. The original tumor was subcutaneous and the 
secondary one deeply placed under the slerno-mastoid. 

The subject of my next case is a ladv named R., who was 
introduced to me by Mr. Nixon, of the London Hospital, with 
whose family she is connected. 

In 1881 I excised from Mrs. R.'s thiirh (the under side of 



Periscope and Abstract. . 97 

the left) a lobulated tumor which had been growing for three or 
four 3^ears in the subcutaneous cellular tissue. It had finally ad- 
hered to the skin, ulcerated, and showed tendency to fungate and 
bleed. I had some difficulty in bringing the skin together after 
its removal, but, notwithstanding the tightness, primary union re- 
sulted. At the time I did this operation, Mrs. P. had a lump 
•deeply placed in the right subclavian triangle. It had been there 
for many years, and showing but little tendency to grow, I was 
■quite willing to let it alone. Three years after the removal of the 
thigh tumor Mrs. R. came back to me with the statement that 
the lump in her neck was increasing and she was afraid one was 
forming in her left breast. This was on May 2, 1884. The 
tumor in her neck presented some features of considerable inter- 
est. It was, perhaps as big as two adult fists placed together, 
and filled the whole of the space above the clavicle. It had 
pushed the trachea over to the right and lifted the sterno-cleido 
muscle and the carotid artery upon its surface. It was rounded 
in outline, quite painless, and did not appear to adhere to any 
structures, unless, indeed, it had an attachment deeply behind the 
sterno-clavicular articulation. The tumor in the breast, about 
^vhich Mrs. R. was anxious, was not bigger than two peas, but 
was very tender. I advised her to wait a month and let me see 
her again. It seemed not improbable thai the tumor was encap- 
iilated, and would shell out by a free incision under its posterior 
surface. 

There were some important facts in her family history. 
Her mother died at the age of 32, and was the subject, among 
other ailments, of cancer of the uterus. A maternal aunt who 
was still living, had had a breast removed 23 years ago on ac- 
count of a tumor which had recurred twice after removal. 

Both Mrs. P. and Mrs. R. were of hght build and rather 
thin. Both had married young and had large families. It will 
be seen that in both cases there had been no recurrence near the 
place from which the tumor had been removed, — the second 
tumor which was present on Mrs. P.'s back having been there at 
the time of the operation. 

I have seen Mrs. R., the subject of my second case, again 
quite recently. The tumor in the neck is growing rather fast. 
There can be no doubt that its rate of increase has been much 
quickened since the removal of the one from the thigh. At the 
time of the operation it was the latter alone which manifested 
tendency to growth. I have advised Mrs. R., in spite of its dan- 
gerous position, to have the tumor removed from her neck, as it 
is likely to cause her great inconvenience and danger before very 
long. My hope is that it will prove to be encaosuled. 



j)8 The Peoria Medical Monthly. 

I think these are examples of an unusual form of tumor^ 
and one which obviously presents an important surgical problem. 
It seems to me very important, in our present state of knowl- 
edge of new growth, that we should endeavor to construct 
clinical groups, selecting for that purpose cases which are really 
in their whole clinical history closely parallel to one another. 
Histology is very helpful, but it cannot give us all that the sur- 
_geon requires for his guidance. — Annals of Surgery. 



NOTES ON NEW REMEDIES. 

April 7, 1S85. John K., aet. 67, has suffered from asthma 
for the past two years. Status prjesens: Emphysema of upper 
lobes; increased resonance on percussion, vesiculo-tympantic re- 
sonance most marked over left lung. Inspiratory sound short- 
ened, and expiratory sound prolonged, low in pitch and blowing. 
Cough and expectoration, cough being spasmodic in character. 
Prolabia and face cyanotic. Patient has not been able to lie down 
for over two weeks. Respirations, 35 per minute. Dyspnoea 
very distressing. Physical examination shows heart to be un- 
affected. 

R. Potassii iodidi, \ ounce. 

Ext. belladonnse, 8 grains. 

Aqiue, 4 ounces. M. 
Sig. A teaspoonful every 3 hours. 

April loth. Patient no better; dyspnoea, if anything in- 
creased, and cough not improved. Constitutional offects of bel- 
ladonna well marked. 

R. Ammonii muriatis, 3 dfachms. 

Spts. etheris nit., 3 drachms. 

Syrup, ipecac, 1 ounce. 

Etheris sulph., 3 drachms. 

Pulv. ext glycyrrhizse, \ ounce. 

Aquam q. s. ad., 6 ounces. M. 
Sig. A tablespoonful every 4 hours. 

April 17th. Cough slightly improved, but no rehef from 
dyspnoea, cyanosis being unimproved. 

R. Ext. (juebracho fluidi. 

p]xt. grindeliic robustte fluidi, 1 ounce. 

Glycerini. 

Aquic, 3 ounces. M. 

Sig. A tablespoonful every 3 hours. 

May loth. Patient reports that improvement commenced 
after taking fourth dose of mixture, and was so rapid that he 



Periscope and Abstract. 99 

diminished the frequency of the dose. He has had no attack of 
asthma, and has been quite free from dyspnoea for over two 
weeks, during which time he has taken no medicine. Respira- 
tions 25 per minute, and cyanosis absent. Has slept more com- 
fortably than for two years. Contracted a slight cold two days 
ago, and from a slight "stuffiness of breathing," is afraid he may 
have another attack of asthma. He requests "another bottle of 
the medicine," in which his faith is very strong. Never took 
anything which afforded him such prompt and permanent relief. 

Grace C, ^t. 12. Capillary bronchitis, following bronchitis, 
affecting the larger tubes. Respirations, 40 a minute. Dyspnoea- 
great, with lividity of prolabia. Subcrepitant rates of low pitch, 
generally diffused. Cough frequent and ineffective. 

Patient was put on the usual expectorants, including carbon- 
ate of ammonia, without, however deriving any benefit, the 
dyspnoea, indeed, becoming so alarming as to prevent her from 
being brought to the dyspensary. She was visited at her home, 
and found to be in an extremely critical condition, it being evi- 
dent that unless the dyspnoea were speedily relieved, apnoea must 
soon follow. 

April 2ist the following combination was administered: 

R. Ext. quebracho fluidi. 

Ext. grindelife robustse fluidi. 
Ext. yerbffi santffi. 

Glycerini, 6 drachms. M. 

Sig. A teaspoonful every 3 hours. 

April 25th. Favorable report having been received, the 
patient was not again visited until to-day, when she was found 
quietly resting on a lounge and breathing easil}^, respiration be- 
ing reduced to 28 per minute. The relief of the dyspnoea was, 
however, apparently disproportionate to the improvement in the 
condition of the lungs, the capillary bronchi being still much 
filled. Medicine continued, 

April 29th. Respiration reduced to 22 a minute, no dys- 
pnoea, cough much improved, and patient convalescent. She 
was put on the following tonic-alternative, and recovery was soon 
complete : 

R. Tr. ferri muriatis, , 3 drachms. 
Liq. potas. arsenitis, 1 drachm. 

Aqute chloroformi, 2 ounces. 

Aqua; font., li ounces. M. 

Sig. A teaspoonful three times a day. 

Wallace C, ast. 18 mos. Has eczema covering completely 
head, face and chest, with extensive excoriations from scratching. 
The surface is angrily inflamed, and there is profuse oozing of 



lOO The Peoria Medical Monthly. 

the characteristic discharge, which has formed into larg'e crusts, 
particuhirly on the head. The eczema hrst appeared when the 
child was but one month old, since when it has been continuously 
treated, several ph^•sicians having- had a trial at it. 
April 1 8th, 

R. Ungt. hydrarg. nitratis. 

Ungt. zinci oxydi, a. a. 2 drachms. 

Ungt. petrolei. 2 ounce. M. 

April 26th. No improvement; an}- benefit which might 
have been secured from the -ointment having been negatived b}^ 
the scratching, which the intense itching made it impossible to 
prevent, 

R. Ext. coese erythrox. fluidi, 3 ounces. 

Aquaj, 5 ounces. M. 

Sig. Wash. 

The coca was thus applied after a suggestion by Dr. J. V. 
Shoemaker, of Philadelphia, who reports excellent results from 
the use of it. 

May I St. Marked improvement in the appearance of the 
eruption. Inflammation almost completely subsided. Since the 
second application of the coca wash there has been no itching. 

May 6th. Improvement continued. Medicine repeated. 

May 1 2th. Eruption somewhat worse, owing, probabably, 
to a severe cold from which the child is suffering. Treatment 
continued. 

Ma}' 20th. Eruption has almost entirely disappeared, only 
a spot of the size of a silver quarter appearing on the right 
cheek. To this an ointment of ungt. ammonia hydrarg,, i part, 
and ungt. petrolei 3 parts was applied. The effect of the coca 
in allaying the inflammation and itching in this case was remark- 
able.— J. J. Miilhcron in Med. Age. 



TREATMENT OF ACUTE PERITONITIS BY AB- 
DOMINAL SECTION. 

The extreme fatality of acute diffused peritonitis, especially 
of that form due to perforation, and the acknowledged futility of 
the modes of treatment that are at present employed, give some 
support to the proposal that acute peritoneal inflammations should 
be treated by the same methods that are successfully applied to 
other acute inflammations, namely, by free incision and drainage. 
This common and general surgical procedure has been already 
applied for the relief of inflammations of certain of the serous 
membranes. It was at first adopted in connection with the 



Periscope and Abstract, toi 

smaller serous cavities, as those of the joints. It has been grad- 
ually and with increasing freedom applied in the treatment of 
inflammatory conditions involving the pleura. It has finally be- 
come a recognized means of treatment in certain forms of local- 
ized and chronic peritonitis, especially when purulent collections 
have formed. 

Mr. Treves, in a paper read before the Royal Medical and 
Chirugical Society at the meeting held March lo, 1885 {British 
Medical Journal March 14, 1885), urged the adoption of this 
principal in treatment in connection with acute and diffused forms 
of peritonitis. A female, aged 21, was admitted into the Lon- 
don Hospital on January 21. suffering from chronic pelvic peri- 
tonitis following severe gonorrhoea. On Februar}- 25, three 
months after the commencement of the chronic peritonitis, she 
suddenl}' developed the symptoms of acute diffused peritoneal 
inflammation. The sequel showed that a large chronic purulent 
collection, containing very offensive matter, had formed near the 
left pelvic brim. The walls of the abscess were formed partly by 
the pelvic peritonium, and partl}^ by many coils of small intes- 
tine that had become matted together. The acute S3'mptoms 
. were due to the bursting of this abscess, and the extravasation of 
its contents into the general peritoneal cavity. On February 26, 
the abdomen was opened under antiseptic precautions, the pa- 
tient being at the time apparently in a very critical condition. 
The general surface of the peritoneum showed the ordinary ap- 
pearances of acute peritonitis. The intestines, where in contact, 
were lightly glued together. A quantity of semi-opaque fluid, 
mixed with flakes of lymph and pus, escaped. The whole peri- 
toneal cavity was washed out with many quarts of water, and a 
drain introduced. The patient made a good recovery, and was 
alloyed in the garden on the fortieth day. Mr. Treves alluded 
to several several cases in which operations involving laparotomy 
have been performed wdth success during the progress of acute 
peritonitis, the cases having been in most instances the subjects 
of error in diagnosis. Allusion was also made to the recent ex- 
periments of Dr. Parkes, of Chicago, as to the treatment of pen- 
etrating gunshot wounds of the abdomen with perforation, Mr. 
Treves ventured to suggest the use of abdominal section in the 
treatment of certain cases of acute general peritonitis, such as that 
following injmy, gunshot wounds, the bursting of an abscess, and 
specified forms of peforation. 

Mr. Howard Marsh read the notes of a case which had 
many points in common with that of Mr. Treves. The patient 
was a medical student, of the age of 19, who was attacked with 
symptoms of acute peritonitis, and admitted under the care of 
Dr. Andrew and Mr. Howard Marsh into St. Bartholomew's 



I02 The Peoria Medical Monthly. 

Hospital. There was no hernia, and nothing abnormal could be 
felt by the rectum; a little to the left of the umbilicus the skin 
was slightly raised and flushed, and there was deep fluctuation, 
with dullness on percussion. A diagnosis of circumscribed peri- 
tonitis was arrived at, and operation was determined upon; the 
state of the patient was very critical, the vomiting violent. An 
incision about two inches in length was made along the linea 
semilunaris, and about two pints of icetid pus evacuated. The 
intestine was found to be much distended, but no cause of ob- 
struction was discovered. The abdomen was thoroughl}^ washed 
out with a solution of carbolic acid, of the strength of i part in 
60, a drainage tube introduced, and the upper and lower ends of 
the wound closed by deep sutures; carbolic dressings were ap- 
plied as dressings for the wound. For two hours the patient 
was cold and collapsed, and he vomited much, probably from the 
ether: then he began to revive, and the vomited matter had no 
fcecal odor, but was merely the contents of his stomach. Mor- 
phine was given, and he was fed by the bowel for several days; 
the sickness ceased entireh' in twelve hours, and it became pos- 
sible to take food by the mouth. The temperature was slightly 
raised, but did not reach loi ; the discharge from the incision 
was profuse, and at flrst very offensive, but after a week it lost 
its odor, and recovery was stead}-, with one trifling intermission, 
when the discharge increased. The peritoneum, in the later 
stages, was washed out with a solution of iodide, i in 1000; and 
after about two months recovery was complete. The cause of 
the peritonitis was not clear; Dr. Andrew agreed with Mr. 
Marsh in thinking it might be due to the bursting of an abscess 
in the mesentery, arising from tubercular glands; that it ex- 
tended very widely was plain, from the large area from which 
pus could be withdrawn by a catheter on the flrst incision. The 
condition of the patient when operated upon was very critical* 
and it did not seem probable to those who saw him that, if im- 
mediate relief had not been found, he could have lived many 
hours. His condition forbade any further proceeding for ascer- 
taining the cause of the suppuration; to evacuate the pus was all 
that could be attempted. The relief was rapid; in six hours the 
pulse was fairly good, though the other symptoms were sq se- 
vere that only his youth enabled him to pull through. The op- 
eration was certainly to be approved for local peritonitis, but 
in general peritonitis any large success was doubtful, for then 
the abscess-cavify was very extensive, and thorough washing out 
of the pus must lead to danger of rupture of the intestine, and, 
even after temporary recovery, adhesions were likely to have 
formed which would be a cause of future danger. Jn this case 



Periscope and Abstract, 103 

there was impaired peristaltic action, which might possibly be 
from adhesions. 

Mr. Bryant thanked both Mr. Treves and Mr. Marsh for 
their contributions to the knowledge of the subject, which was, 
taken in all its bearings, a large and important one. The op- 
eration recommended was, after all, only the apphcation of well- 
known surgical principles to abdominal suppuration. Opera- 
tions for- the relief of perityphlitic abscesses were som'etimes 
regarded as extraperitoneal; but that was a mistake, as Mr. 
Treves had lately clearh^ demonstrated in his excellent lectures 
at the College of Surgeons. For himself, he had long felt that 
such abdominal operations ought to be carried out; their results, 
it must be allowed, would depend very largely upon what was 
the cause of the peritonitis: it might be due to a wound, a per- 
forating ulcer, or a burst abscess. In cases of perforating ulcer 
of the c«cum, he was decidedly of opinion that operation might 
do good. Mr. T. Smith had put on record a very valuable in- 
stance of its success in such a case in St. Bartholomew' 9, Hos- 
pital Reports, vol. ix., 1873. 

Mr. Knowsley Thornton wished also to express his thanks 
to the authors of the papers. At the present day, it would be 
difficult to find any surgeon bold enough to blame such surgical 
operations as those of Mr. Treves and Mr. Howard Marsh. He 
had himself been sorry that the phrase used as describing the 
disease was not acute suppurative peritonitis, for that, in his ex- 
perience, was a much easier state to deal with than simple acute 
peritonis. This latter state occurred sometimes apparently idio- 
pathically where there were tumors in the abdomen; there might 
be no escape from the tumor, and yet such a state might come 
on, apparently from chill. In such conditions, where there was 
an ovarian tumor, and simple acute peritonitis supervened, he had 
twice opened the abdomen, and found, on both occasions, the 
peritoneum intensely congested, but quite dry. The first case 
died soon after the operation, with suppression of urine and col- 
lapse; and subsequent reflection led him to the conclusion that it 
would have better to have waited longer before operating. In 
the second case, there was a large ovarian tumor, the peritonitis 
was very acute, and the state extremely hazardous. He was 
induced to operate by the impression that there w^as abdominal 
hemorrhage. It turned out that he was wrong; no hemorrhage 
was found, but the same condition of acute dry peritonitis. The 
woman, however, recovered, after passing through a state of ex- 
treme peril. This experience had convinced him that that was 
not a suitable stage for operation. Mr. Treves had, unfortun- 
ately, not stated whether, in his case, the peritonitis was dry or 
not. If it had been possible to incise the peritoneum, to relieve 



I04 The Peoria Medical Monthly. 

the congestion, it would have been a good thing: but that was 
out of the question, and the alternative was to wait until a sub- 
acute stage or a stage of effusion was reached. In perforation 
or gunshot wounds, he should prefer to operate at once, to try 
to close the opening in the bowel, to clear out the matters that 
had escaped into the abdomen, and to drain the cavity. Drain- 
age was important, as it was nearl}- impossible to be sure that 
all obnoxious contents were cleaned out during the operation. 
In gunshot wounds, it was hardly likely that the results would 
be quite satisfactory, for the edges were not such as could easily 
be brought together, and onh' after somewhat perilous resection 
in the track of the ball could good union be expected. As to 
the method to be used in operation, he generall}- advocated Lis- 
terism, and all antiseptic precautions; still, he held strongly that, 
if it were impossible to be sure of making wounds antiseptic, it 
was better to leave antiseptics entirely alone. In these abdom- 
inal cases, it was often so impossible to be sure of attaining a 
completely antiseptic condition that he preferred, as a rule, to 
leave Listerism entirely alone, and to wash freely with boiled 
water at the temperature of the body, and then to dress the ex- 
ternal wound antiseptically until it could be seen whether the 
subjacent parts are antiseptic. 

Dr. Douglas Powell was extremely glad that his surgical 
brethren were beginning to treat peritonitis as the}' had treated 
pleurisy, and to recognize two classes of cases, namely, («) the 
suppurative, which required early surgical treatment; and ((^) 
the serous or idiopathic, which were less fitted for operation. 
Mr. Treves's paper would tend to place effusions into the peri- 
toneum on the same footing as effusions into the pleura, and to 
lead it to be recognized that in effusions of pus, surgical treat- 
ment only could be efEcient. He demurred to Mr. Thornton's 
preference for boiled water, and should expect, in such cases, 
suppuration in the residue of the abdominal contents. He should 
himself incline to the use of a weak mercurial solution, such as 
Mr. Pearce Gould had successfully used in a case under his care. 

Mr. Barwell gave some details of a case of suppurating peri- 
typhilitis, in which he had made an opening in the flank, and a 
counter-opening in the loin, by which he had evacuated twenty- 
four ounces of foetid pus from within the peritoneum. The 
wound was long syringed out with a weak carbolic solution, and 
at last closed completely. The patient died eighteen months 
after the operation, of phthisis; but he thought himself justified 
in saying that life was prolonged by the operation. He felt him- 
self in substantial accordance with Mr. Treves as to the benefit 
to be obtained from such operations, but expressed his convic- 



Periscope and Abstract. 105 

tion that in these cases the surgeon was almost always called in 
too late. 

Dr. Goodhart took surgery in general somewhat severely 
to task for its aggressive habits in attacking the physician's ter- 
ritory. Mr. Treves, however, he had found cautious and kind. 
He would have been glad to have heard rather more of non- 
suppurative peritonitis, and those frequent cases in which there 
was too little effused fluid for the surgeon to deal with. Such 
cases often died very suddenly, like dogs injected with sepsin. 
He had seen one such case benefitted by surgical treatment. A 
colleague of his was going to perform, in a case of peritonitis, 
what he believed he was right in calhng Littre's operation; and 
he was performing it by two stages. In the first stage an in- 
cision was made, and the intestine stitched to the walls of the 
cavity. A very little turbid fluid was let out; and no more was 
done, for it was found that that had sufficed to alleviate the 
symptoms completely. In ascites, he thought there was room 
for more surgical treatment. It often happened that such cases 
died after having been very frequently tapped — perhaps ten or 
twenty times. In such cases, incision and drainage might have 
succeeded better. One case had been reported as " cirrhosis 
cured by tapping." Of course, it was not the cirrhosis, but only 
the ascites, that had been cured; and that had been effected by 
the union of the visceral and parietal layers of the peritoneum, 
after the evacuation of fluid and the establishment of a collateral 
circulation. 

Mr. Meredith expressed his substantial agreement with all 
that Mr. Thornton had said, especially as to disuse of antiseptics 
in abdominal operations; for solution of carbolic acid of the 
strength of i in 40 had been found insufficient to arrest putrefac- 
tion, and no stronger could be used in the^e cases. 

Dr. Douglas Powell remarked that he had advised the use 
of weak solutions of perchloride of mercury, and commented 
also on the advisability of using a h3-podermic syringe before 
operation in order to determine the nature of the effusion. 

The President asked if it would be thought desirable to call 
in surgeons in cases of perforation of the stomach by simple ul- 
cer, where the symptoms of acute collapse were generally pres- 
ent, and the cause plain. Certainly, if the case were left to the 
ph3'sicians, there was very small chance of recovery. In his ex- 
perience, he had only met with one such case; the symptoms of 
perforation of the stomach had seemed distinct, but the recovery- 
led to some doubt being thrown on the diagnosis. The stomach, 
at the time of perforation, had fortunately been very empty. 

Mr. Harwell expressed an opinion in favor of operation in 
such a case. 



io6 The Peoria Medical Monthly. 

Mr. Treves, in reply, noticed some objections to the opera- 
tion which Mr. Marsh had brought forward, namely, the large 
size of the abscess, the dithcultv in removing the pus, and the 
danger from resulting adhesions. He could not admit that the 
first two were insuperable objections, as, indeed, Mr. Marsh's 
own favorable case had shown, and the danger from adhesions 
was too distant and uncertain to have any practical influence in 
determining what should be done in these cases, in w^hich there 
was generally a pressing question of Hfe and death. Mr. Thorn- 
ton had said that, in cases of dry peritonitis, it w^as unfortunately 
impossible to relieve the intense congestion by incision, but he 
ventured to think that the opening of the cavitv would in itself 
tend to relieve the congestion. Mr. Thornton had advised wait- 
ing in such cases, but most of such cases w^ere dying, and could 
not wait. He related a recent a recent case of gunshot wound 
of the abdomen, in which the bowel was perforated in four or 
live places. The abdomen was washed out; no resection was 
thought necessary; the wounded edges were adjusted, and the 
operation was followed b}^ complete recovery. The objection 
to the use of the perchloride of mercury which Dr. Douglas 
Powell had advocated, w'as that it formed an albuminate, and its 
antiseptic properties were thereby much diminished. As to the 
operation in the case of perforating ulcer of the stomach, such as 
the President had described, he could not bring forward any ex- 
perience, but he knew that man}' surgeons were anxious for an 
opportunity to operate upon them. 

Mr. Howard Marsh explained that he quite agreed with 
Mr. Treves in wishing to perform these abdominal operations, 
that he thought it right to dwell on the difficulties of thorough 
drainage, and that his reference to subsequent abdominal adhes- 
sions had arisen from his recollection of a case where he had 
seen death result from such adhesions. — Therafentic Gazette. 



THE THERAPEUTIC VALUE OF ARSENIC IN AN- 
EMIA AND ATROPHIC CONDITIONS. 

Dr. Samuel Wilkes in the Lancet for April ii, writes 
strongly in favor of arsenic for many diseases where skepticism 
as to its use on the part of a large portion of the profession has 
generally prevailed. There can be no doubt that many of the 
affections cured by arsenic have a gouty origin, and therefore it 
is not surprising that the same remedy has a great power in pre- 
venting attacks of gout. Then, this gouty class of jiersons are 
often neuralgic, and it may be in them especially that arsenic is 
the best nervine remedy. He has found it amongst the most 



Periscope and Abstract, 107 

efficacious medicines, and in some cases the only remedy. Thus, 
before the introduction of nitrite of amyl and glonoine for angina 
pectoris, he rehed mainly on arsenic, and in some cases kept off 
attacks for weeks where they had previously occurred almost 
daily. But the most remarkable effects of this remedy are seen 
in anaemia and various forms of cachexia and atroph3% One case 
which he cites was a lady about forty years of age, who was 
pronounced to be the subject of idiopathic anaemia. Her blood- 
less and feeble condition compelled her to keep her bed, and it 
was never believed that she would rise from it again. Arsenic 
was used, she began to improve, and in a few weeks was able to 
visit her doctor at his house. Her husband was not surprised at 
the action of the remedy, for, as he said, if he had a horse which 
was not " thrifty " he gave it arsenic, rendering it again plump 
and glossy. Another case of the so-called pernicious anaemia 
w^as in a gentleman who had gradually grown ana?mic and 
breathless, so as to be unable to leave his house, and he walked 
with much difficulty. He took live drops of liquor arsenicalis, 
and in a month he was comparatively well. In most of the cases 
"where arsenic has succeeded, iron had previously failed. It is, 
however, in wasting and general cachexia that Dr. Wilkes has 
been the most pleased with its action. He details several cases 
where there were evidences of extreme wasting and debility, at- 
tributed to no special disease, and where arsenic effected cures. 

He has never given very large doses, generally four or five 
drops of the liquor arsenicalis three times a day, or a little more 
of the soda preparation; nor has he observed any injurious effects 
from its long use, although, as is known, it becomes absorbed in- 
to the system, the urine showing its presence many weeks after 
its administration has ceased. 

An editorial on this article, in the same number of the Lan- 
cet^ considers Dr. Wilkes' testimony of great value, as coming 
from one who is far too much imbued with scientific caution to 
lavish undeserved credit on an}' pharmacopoeial preparation. 
The testimony of Dr. Wilkes on its efficacy in idiopathic anaemia 
is borne out by the experience of man}- physicians; among the 
most recent being Dr. Warfinge, of Stockholm, who reported 
several cases of remarkably rapid arrest of the downward pro- 
gress of the disease, and. even of recovery, under the use of 
arsenic. All such cases should, however be subjected to pro- 
longed supervision, as it is notorious that relapses are prone to 
occur. The same remedy has been also successfully employed 
in an even more definite cachexia^ — viz. : Hodgkins' disease, 
where the administration of arsenic has been supplemented by 
its injection into the h3'perplastic Ivmphatic glands with, accord- 
ing to Winiwarter, astonishing results. — Aledical Progress. 



loS The Peoria Medical Monthly. 

CHOLERA. 

Prof. Bartholow says as the cholera discharges are dis- 
tinctly alkaline the universal outward osmosis can only be 
checked by the administration of an acid. He recommends for 
the preliminary diarrhoea: — 

R. Acidi sulphuric aroruat, i ounce. 

Tine, opii deod, h ounce. M. 

Sig. Twenty drops in water every hour. 

Or 

R. Acidi sulphuric dilut, J ounce. 

Tinct. opii camph., li ounces. M. 

Sig. A teaspoonful well diluted every hour or two. 

Many prefer acetate of lead and opium in pill form or in 
solution. A favorite combination with others is spirits of chloro- 
form, tincture of rhubarb, tincture of cinnamon, and tincture of 
opium. 

Another efficacious remedy is the hypodermatic injection of 
morphia, gr. 5^ and atropia gr. jl-j^. Mustard to the epigastrium 
or a fly blister will aid in the arrest of vomiting. Other reme- 
dies for the vomiting stage are carbolic acid, chlorodyne, 
camphor, chloroform and the hypodermatic administration of 
morphia and chloral. Both in this and in the algid stage Prof. 
Bartholow has obtained the best results frow the internal use of 
sulphuric acid combined with the employment hypodermatically 
of morphia and atropia followed by chloral. He considers 
chloral to be more efficient in the treatment of the later stages of 
cholera than any other single remedy. It frequently allays the 
vomiting and purging, relieves the cramps and brings about re- 
action as if by magic. This result is obtained by its action upon 
the nervous system, where the poison of cholera seems to spend 
its force. In desperate cases Prof. Bartholow recommends the 
intravenous injection of salines. 

After reaction has been secured the urinary secretion must 
be restored in order to void a fatal result from uraemia or cholera- 
typhoid. 

Prof. DaCosta says that success in the treatment of cholera 
depends in great measure upon the treatment of the preliminary 
diarrhcL-a. Check it and the general mortality will be decidedly 
lessened. Years ago he was impressed with the value of sul- 
phuric acid in this stage. A valuable combination is — 

K. Acidi Hulphurici, dilut., 10 minims. 

Tinct. opii, deod, 10 minims. 

Aqua menth., pip., 2 drachms. 

To be taken every fifteen to thirty minutes until the diar- 
rhoea ceases. 



Periscope and Abstract. 109 

The experience of physicians in India has shown that good 
resuhs may also be obtained in this stage from the administration, 
every three or four hours, of — 

R. Plumbi acetatis, 4 grains. 

Pulv. opii, 1 grain. 

Aqua, 2 drachms. 

If the case be one of more than ordinary severity a pill com- 
posed of capsicum, opium, and campor will often produce a most 
happy effect. 

R. Capsici, 4 grains. 

< 'amphorae, 8 grains. 

Ext. opii aq , 2 grains. 

M. Ft. piliulffi No. IV. 
Sig. One pill every half-hour. 

If the case still go on, and vomiting, purging, with cramps, 
and rice-water discharges occur. Prof. DaCosta says that the first 
and most important thing to do is to stop the patient from drink- 
ing any fluids whatever. His experience in this respect agrees: 
with that of McNamara and the Indian physicians. The patient 
may be allowed to swallow small pellets of ice which will allay 
the thirst without overloading the stomach. The whole abdo- 
men should be covered with a mustard plaster to lessen the 
cramps, nausea and vomiting. Medicinally, capsicum, opium, 
and camphor are still to be depended on, but they had better be 
given in liquid form now, and in small frequent doses. 

R. Tinct. capsici, 2 minims. 

Tinct. opii, deod, 10 minims. 

Aq. camph., 2 drachms. M. 

Sig. For one dose. To be repeated every half hour. 

If the stomach be too irritable to retain the medicine, mor- 
phia may be given hypodermatically. Friction with dry mustard 
is invaluable for the cramps in the extremities. At times they 
are relieved in a marked manner by the hypodermatic injection 
of chloral, gr. xv-xxx, largely diluted. 

If the various astringent remedies have failed to arrest the 
excessive secretion and the case . is progressing favorably, ex- 
perience has shown that the alterative plan may be resorted to 
with advantage. Some physicians advise repeated large doses 
of calomel. Prof. DaCosta has obtained more benefit from the 
administration of one dose of gr. v, to be followed by small doses 
of gr. ]^ every hour. 

If collapse be impending, friction with hot mustard, hot tur- 
pentine, or hot whisk}^, must be persistently employed, and small 
amounts of warm whisky or brandy given every few minutes by 
the stomach or hypodermatically. The hypodermatic use of 



no The Peoria Medical Monthly. 

caffeine, in gr. iss. doses, is warmly recommended by some of the 
most distinguished French therapeutists. If the patient is still 
failing, blood-letting has been proposed as a last resort, and has 
been used with success in some cases. Absorption and circula- 
tion appear to have been restored as soon as the venous stasis 
was removed bv the withdrawal of a quantity of thickened blood 
from the yeins. 

Prof. DaCosta is convinced, however, that the best results 
in this apparently hopeless stage will be obtained from the intra- 
venous injection of salines. The effect of this procedure in the 
cases reported was mavelous. A ver}' good formula for the 
solution is. 

R. Sodii chloridi, 1 drachm. 

Sodii earb., 3 drachms. 

Aqua, 6 pints. M. 

Warm to the temperature of io8 ° and slowly inject 2 
ounces per minute into a vein until 40 ounces have been thrown 
in. If necessary 40 ounces more ma}^ be injected after a short 
time, but it will not be advisable to exceed that amount. 

After reaction has been established there is still danger of 
death secondary irritative fever or from ureemia due to the clog- 
ging of the uriniferous tubules with cast-off epithelium. — Med. 
Bulletin. 



VESICAL EXPLORATIONS. 

Morbid conditions of the bladder and prostate may or may 
not be easily diagonosticated. Given a certain well known ag- 
gregation of rational symptoms and the presence of a stone may 
be confidently assumed; certainly of its existence being shown if 
the proper physical signs are manifested when the uretha and 
bladder are thoroughlv sounded. But, on the one hand, though 
a calculus be present it may be so small as to escape detection 
(caught perhaps between two thickened mucus folds), may be 
sacculated, may rest in a pocket behind the prostate partly or 
wholly below the bladder level, or may be of such putty-like 
consistence as to give out an uncertain muffled sound when 
touched; or, on the other hand, an incrusted ridge or tumor ma}^ 
distinctly "click" when struck by the searcher. 

Again, the rational signs being present but the physical ab- 
sent, rectal palpation may reveal tubercular disease of the pros- 
tate and seminal vesicles, associated probabl}^ with similar dis- 
ease in the testis, the vas deferens, or some more remote part of 
the body. 

Exploration with the sound and with the finger in the rec- 



Periscope and Abstract. hi 

turn will usually determine the existence of prostatic hypertrophy^, 
but limited enlargement of the third lobe will sometimes escape 
detection. 

Careful sounding with searcher or lithotrite may make man- 
ifest the presence of a vesical tumor, even approximately its size; 
or occasionally by palpation, rectal thickening and induration 
may be located. 

Endoscopic examinations, of which so much was at one time 
hoped, have, as a rule, even when made by experts, proved of 
little value: such exploration, however, being much more satis- 
factory in the female than in the male. 

Generally then the before-mentioned methods of explora- 
tion, one or more, will, (when supplemented, as they always 
should be, by an urinalysis, chemical and microscopical) suffice 
to indicate very clearly the nature of an existing vesical trouble; 
but in certain cases, proportionately few in number it is true, the 
diagnosis is but inferential. It is in these that the quite recently 
introduced digital expl(5ration affords information of the highest 
value; a method the credit of systematizing which is due to Sir 
Henry Thompson. B}^ the ordinary perineal section the mem- 
branous urethra is opened, the prostatic portion of the canal is di- 
lated, and the finger pushed on into the bladder. The condition 
of the prostate and the das fond determined; by supra-pubic 
pressure with the other hand the fundus is readily brought within 
reach of. the finger tip, and the whole mucus surface can be pal- 
pated, its irregularities noted the presence, location, size and 
character of growth ascertained and a concealed foreign bod}^, 
even a stone in the lower part of the ureter, discovered. In two 
■cases which I have latel}- thus examined the condition of the 
bladder was practically as readily and thoroughly ascertained as 
if the cavity had been opened up -post mortem. Although, and 
this is an objection that has been strongly urged against the 
method, in very fleshy subjects, or when the perineum is un- 
usually deep, or when the prostate is greatly enlarged, it may 
be difficult to reach and impossible to explore the bladder dig- 
itally, 3^et in the great majority of patients the finger can be made 
to sweep the surface of the bladder, and no one without having 
actually tested it ean, I am sure, appreciate the ease and com- 
pleteness with which by pressure upon the lower anterior ab- 
dominal wall (under an anaesthetic, of course), the upper seg- 
ment of the bladder can be brought within reach of the finger 
introduced through a perineal opening. The operation is a sim- 
ple one. merely the ordinary external perineal urethrotomv upon 
a grooved staff; and, per se, is almost devoid of danger, as much 
so I think I may safely say as amputation of a finger. Of course 
the subjects of perineal section not infrequently die, and a pdv- 



112 • The Peoria Medical Monthly. 

centage of those digitally explored will without doubt die (within 
a few days perhaps, more likely weeks) ; but the fatal result in 
neither class is, other than most exceptionally, due to the ure- 
tlirotomv. Guvon and certain of his followers amon"- the French 
surgeons, who advocate the supra-pubic rather than the perineal 
operation, have strongly insisted that there is positive danger in 
the dilatation of the prostatic urethra because of- the lacerations 
thereby produced; and perhaps more extended experience may 
show that there is some ground for their objection to the ex- 
plorator}^ urethrotom}^ But the danger certainly is not grave^ 
and the advantages of an accurate diagnosis are great. 

What one of us who has had any considerable experience in 
the surgery of the urinary organs cannot recall a case or cases 
in which had he known before what he ascertained after death, 
and which he would have known had he carried his finger inta 
the bladder and swept its surface, he might readily have relieved 
if not absolutely cured? Three times on autopsy I have seen an 
hypertrophied third lobe that, acting like a ball-valve, had in- 
duced fatal disease of the bladder and kidney; in each of which, 
cases digital exploration would have readily estabhshed the 
diagnosis, and through the perineal wound the growth might 
easih' have been snared and removed. 

Intra-vesical growths have time and again been permitted ta 
develop, exhausting and ultimately destroying the patients, for 
the simple reason that the diagnosis was uncertain, and abso- 
lutely nothing was known respecting size, location, or manner of 
attachment. Digital exploration could have revealed all that 
was necessar}' to be known, and in many a one of the cases the 
growth could have been taken away through the original open- 
ing, or, as in Billroth's case ten years ago, through a second and 
larger one above the pubes. Even if the exploration shows that 
there is nothing to be or that can be taken away, the operation 
wound will greatly facilitate that cleansing that so much increases, 
comfort and prolongs life. For every reason, both as respects 
diagnosis and treatment, digital exploration should always be 
made when the other more ordinary and long-practiced methods 
of examination have proved insufficient. In quite young chil- 
dred lateral rather than median urethrotomy may be performed; 
.since such operation does not materially increase the danger to 
Hfe, and relieves the surgeon of the trouble, at times quite con- 
siderable, of dilating the prostatic portion of the canal. — P. S, 
Conner in I^ancet and Clinic. 



Stuart recommends the following liniment in lumbago: 

Tincture of" capsicum, 1 ounce. 

(Jlive-oiJ, 6 ounces. 



Periscope and Abstract. 113 

NERVE-STRETCHING. 

The following summary, gleaned from the " Bradshawe " 
lecture, delivered by John Marshall in December last, gives us 
the principal information now in our possession in reference to 
this recent operation. In the operation of nerve-stretching there 
is a palpable stretching. Nerves nearer the spinal cord are rather 
more extensible than those at a distance. This may be owing to 
the relatively less thickness of the sheath. The distant nerves 
.are smaller, but they are probably better protected. The nerves 
of the upper limb are more extensible than those of the lower 
limb, probably for the same reason that the nerves of the lower 
limb are better protected by sheaths ; for we must recognize that 
it is the sheath that bears the strain when we pull upon a nerve. 
After a nerve is stretched it recoils. One observer states that 
after stretching a nerve it recoiled one-fortieth of its length. The 
safe therapeutic weight varies from i Bb. up to 30 lbs. The 
former, for the smaller nerves, as the mental, the latter for the 
great sciatic. When nerves are stretched, the epi and peri- 
neurium lose their wavy appearance and become straightened; 
the segmentation of the medullary sheath gives way to an irreg- 
ular breaking up. Sometimes the tubuli break; and still more 
rarely the axis cylinder gives way. After this the nerve degen- 
-erates, and after the whole mass of nerve has become dismteg- 
rated, restorative changes follow and its function is gradually 
restored. Sensation and motion are the first to be extinguished, 
and lastly reflex action. 

Effects on the cord. — Practically there is no stretching me- 
chanical effect propagated through the roots of the nerves to the 
spinal cord. In the sciatic, the stretching effect passes to the 
sciatic plexus, passes to the roots of the nerves, where it must 
disturb the spinal ganglia on the posterior roots and it must dis- 
turb the dura mater. It may by disturbing the dura mater shake 
the cord a little through the ligamentum denticulatum on either 
side, but we find no change of tension in the intra-spinal or intra- 
meningeal part of the nerve, and no movement in the cord. The 
effects are bilateral. The effect of stretchingr nerves on one side 
passes over in various degrees to the other side of the nervous 
system. 

Therapeutics. — Specially successful in peripheral paralysis 
and neuralgias of all kinds; less so in tetanus; still less so in ep- 
ilepsy and tabes. In the case of neuralgia, the presence of nervi 
nervorum is assumed, and that it is through the rupture of these 
that the pain is got rid of. Nerve-stretching is said to act, not 
only by rupturing the assumed nervi-nervorum, but in other 
cases by partially benumbing or paralyzing the internal tubules, 
arresting their function for a time, or, further, by indirect effects 



114 The Peoria Medical Monthly. 

on nerve centres. In tabes and central neuralgias it is said to act 
by producing some indirect effect upon central nerve elements 
through trophic changes, probably induced by the disturbance of 
vasi-motor action. 

The operation is performed, with one exception, by exposing' 
the nerve, lifting it with the thumb and finger until a -palfahle 
stretching is produced. Sufficient force is to be used until the 
nerve sensibly yields to your traction — until you feel an internal 
creeping movement in the particles of the nerve, of the sheath, 
no doubt ; until you feel a Certain attrition and vibration going on 
— and 3'ou must educate yourself to that, and then you will be 
safe. The thumb and finger can stretch with a force equal to a 
weight of 30 lbs., the amount said to be sufficient for the largest 
diseased nerve, the sciatic. Stretch both ways for neuralgia. It 
is of less consequence to stretch from the extremities in tabes; it 
is essential to stretch from the trunk or body. A continued even 
force, firm and resolute, is desirable. Without cutting Sayre 
reports, a positive improvement in tabes in thirteen out of fifteen 
cases, from the use of his suspensory apparatus, for ten minutes 
ihree times a week, the sciatic can be well stretched by forced 
flexion of the lower limb. It appears from the above that the 
cutting operation should not be resorted to for tabes. The dan- 
gers are those of chloroform, thrombus, pyaemia, and diseases of 
the spinal cord, set up by the operation. — Canada Lancet. 



A NEW TREATMENT OF EPITHELIAL CANCER. 

Experiments now in progress, under the supervision of Dr. 
J. E. Garretson, at the Oral Hospital of this city, show a wonder- 
ful curative value in the treatment of epithelial cancer with the 
use of epiderm secured from the horse by means o^ a curry- 
comb, the treatment being nothing more complex than keeping 
a sore continuousl}^ covered with the ash-colored powder thus 
obtained. The horses are to be washed over ni^ht and curried 
with a new curry-comb in the morning. After picking out the 
hairs the hairs the powder is ready for use. When horse ep- 
idermis is not to be obtained, the scales may be scraped by means 
of a knife-blade from the human arm or leg. — Med. and Surg^ 
Reporter. 



To render blood more coagulable — when we have effusions of 
the same into cavities and so cannot ligate the bleeding orifices,. 
Prof. Gross advises — 



Periscope and Abstract, 115 

R Acidi gallici., 2 grains. 

Digital! foliorum, 

Ergotin., aa 1 grain. 

Opii, i grain 

Sig, — Ter die. 

When the stomach is irritable, so that medicines cannot be 
retained, and if it should be necessary to purge the patient, Prof. 
Gross recommends the following injection, should there also be 
much tympany: 'Oil of turpentine, }4 oz., rubbed up with the 
yolk of one egg, then add castor oil i^ oz., warm water, i pint. 
To be used as an injection. — Co/, and Clin. Record. 



ELECTRICITY IN THE TREATMENT OF INTES- 
TINAL OBSTRUCTION. 

Boudet iyProgres J/^c/. ) reports seventy cases which were 
treated in this manner, with only seventeen failures. He prefers 
the constant current, which he applies in the following manner: 
A metal tube connected with the battery is inserted into a gum- 
elastic rectal tube which has a lateral opening near its end. The 
two tubes are passed into the gut as far as possible, and a quan- 
tity of salt water is then injected; this fluid forms a safe 
and efficient electrode, and prevents ulceration of the 
mucous membrane from direct contact with the pole. The 
other electrode is placed over the small of the back. A moderate 
current is employed, the semice laeting from five to twenty min- 
utes. With the exception of simple aton}^ the writer does not 
express himself clearty concerning either the causes of obstruc- 
tion or the rationale of his method of treatment. He does not 
regard acute enteritis or peritonitis as contra-indications to the use 
of electricity. Even in cases of actual stenosis from ulceration or 
malignant disease he has great faith in the power of the constant 
current. — M. T. Med. Jour. 



DECOCTION OF LEMON IN THE TREATMENT OF 

URETHRITIS. 

Rebatel [Annales de SvpkHig-r) commends this simple rem- 
edy, which was first suggested by Mannino. It is said to destroy 
at once the vitality of the gonococcus. Three fresh lemons are 
cut into small pieces and thrown into about ten ounces of water, 
which is reduced by boiling to three ounces. With this fluid 
three or four injections should be employed daily. After two 



ii6 The Peoria Medical Monthly. 

days a fresh decoction should be made. The following combina- 
tion may be used instead: 

Salicylic acid, 1 grain. 

Citric acid, 25 grains. 

Water, 8 ounces. 

Two injections are to be made daily. — Ibid. 



CHROMIUM IN THE TREATMENT OF SYPHILIS. 

Guntz {^Memorahil^ speaks highly of this drug in cases of 
syphihs which resist treatment with mercury, and in which the 
constitution has been badly broken down by the disease. Not 
only is the:e a complete absence of general disturbance after the 
use of chromium, but, according to the writer, the cure is rapid 
and complete. The daily amount which he employs is half a 
grain of potassium bichromate, divided into four doses. Guntz 
denies that the headache ever follows the use of the drug. — Ibid. 



AN APPLICATION FOR SYPHILITIC ERUPTIONS. 
Maurice ( Union 3Ied.) suggests the following: 

Chloral hydrate, 2 drachms. 

Tincture of eucalyptus, 5 drachms. 

Distilled water, 2 pints. 

To be applied to mucous patches and ulcerating syhilides. — 
Ibid. 



A MIXTURE FOR GASTRALGIA. 

Lasegue and Regnauld ( Union Med. ) prescribe this mix- 



ture: 



Orange- flower water, 5 ounces. 

Chloroform water, 15 ounces. 

Distilled water, 9 ounces. 

Dose, a desertspoonful every fifteen minutes until the pain is re- 
lieved. — Ibid. 



A MIXTURE FOR CARDIAC DYSPNCEA. 

See [Ibid.) suggests this syrup: 

Tincture of iodine, 75 minims. 

Syrup of horse-radish, ) , r- 

Q,..,..t. .i-^ c each, 5 ounces, 

hyrup 01 poppy, ) ' 

Dose, a teaspoonful three times a day. — Ibid. 



Therapeutic Notes. 



117 



THERAPEUTIC NOTES. 

Taken from Lectures iif N. Y. Polyclinic, l>y E. L. Fridenberg, M.D , Peoria, 111. 



VARICOSE VEINS. 

Fluid extract hamamselis (Billiard & 
Crenshaw's') in teaspoonful doses three 
times a day. This treatment should 
be kept up' for at least four months, 
and will give relief in every case, and 
in a majority of cases will etfect a cure. 

EEYSIPELAS. 

Wash the parts with buttermilk 
every three hours, and give internally 
tincture of iron and quinine. 

GONORRHOEA. 

Take sol. of corrosive sublimate, 
1-500, (holding tight the uretlira so as 
not to allow solution to enter the blad- 
der) and inject two or three times, then 
wash out excess with pure water, and 
then give Vichy salts. Generally one 
sitoing will perfect a cure. In the 
more chronic form of gonorrhoea use 
the following: 

R Lig. plumbi subacet dil. 7 ozs. 
Zinci accetatis, 5 grs. 

M. tl. sol. 

Sig. Inject three times a day. 

CONDYLOMATA ON TONGUE IN SYPHYLIS. 

Treat the same with the following: 
R Corros. sublimate, 15 grs. 

Ether, 2 ozs. 

M. fi. sol. 

Sig. The physician himself should 
apply this 

STONE IN THE BLADDER. 

R Acid benzoici, }/2 ^o 1 ^^'• 
Soda bicarb, 1 to 3 dr. 

Aquae, 5 ozs. 

Sig. Teaspoonful 5 times a day. 

TO DELAY HARDENING OF PLASTER 
PARIS. 

Add beer or milk. If plaster is old, 
put in a pan over lire. 

HOW TO PREPARE ANTISEPTIC GAUZE. 

Take ten yards of cheese cloth, boil 
in water, and after it is dry place in a 
solution of liq sodse chlor. (1 pt. to 2 
pts. water), and allow it to remain in 
this solution for forty-eight hours, after 
which time it should be taken out, 
dried, and placed in a jar of sul. corros. 
sublimate (1-5000) until wanted, when 



it should be taken out and wrapped in 
protective. Just before using it should 
be put in a sol. of corros, sublimate- 
(1-5000), and then squeezed out, when 
it is ready to be put on the patient. 

IODOFORM GAUZE. 

Dip dry gauze in sublimate solution 
(1-5000) and pepper it well with iodo- 
iorm. 

TO MAKE SOLUTION OF CORROSIVE SUB- 
LIMATE. 

R Corros, sub., 30 grs. 

Glycerine, % drm. 

Water, 1 oz. 

Salt. 20 grs. 

Sig. Two teaspoonsful to pint o^ 
water equals 1 2000. 

ABSORBENTS. 

Take clean cotton, boil it, dry it, and 
then place it in a 1 to 5 Labarrque 
solution, and put it in a solution of 
boracic acid, 15 grs. of boracic acid to 
1 oz. of water. 

HOW TO PREPARE SPONGES 

Get nice sponges, string them and 
whip thoroughly until sand and dirt 
is out of them, then put them in a so- 
lution of liq. sod. chlor. (1 to 5), and 
allow them to remain for forty-eight 
hours. Then dry them and keep in a 
glass jar. 

Method No. S.— Whip, put in sol. 
permanganate potassium (5 grs. to 1 
oz water) for for one-half hour. Take 
out, wash in clear water, then dip in a 
solution of oxalic acid (1 oz to 40 ozs. 
water); leave in one-half hour, then 
wash out in clear water and let them 
dry in sun or hot oven. 

CATGUT SUTURES. 

For majority of operations four sizes 
of cat gut are needed — E, A and G 
violin strings and minor harp. For 
amputations G strings. Take the 
strings, cut off the ends and place them 
in bottle containing either alcohol or 
ol. juniper berries. 

DRAINAGE TUBES. 

Take chicken bones, place them first 
in ether then in a 33 per cent solution 
of hydrochloric acid for twelve hours, 
after which put in alcohol unitl needed. 



THE 

Peoria Medical Monthly. 



THOS. M. McILYAINE, A. M., M. D., 

Editor and Publisher. 
204 S. Jefferson St., Peoria, III. 



***The Editor is not responsible for the statements or opinions of contributors. 

***Short original articles are invited from any reader, whether a subscriber or not. 

*»*If extra copies are desired by a contributor, the number must be specitied when the 
article is sent to the Editor. 

*:::*A11 cxchauges, books for review, and commiimications must be addressed to the Editor 
and Publisher. 

***The publication day of this journal is on or about the 25th of each month. 



EDITORIAL. 
THE INTERNATIONAITmEDICAL CONGRESS. 

Doubtless most of our readers are more or less acquainted 
with the arrangements which had been made for the meeting of 
the International Congress at Washington, D. C, in 1887, and 
but few are ignorant of the fact that a most untimely controversy 
has arisen over the power of the committee of arrangements ap- 
pointed by the American Medical Association in 1884. Yet 
we believe a resume of the history of the actions of the Associa- 
tion and the committee will be of general interest. 

At the meeting of the American Medical Association held at 
Washington in May, 1884, a committee of seven members was 
appointed to extend on behalf of the medical profession of the 
United States, to the International Medical Congress about to 
meet at Copenhagen, a cordial invitation to have the next con- 
gress meet in Washington in 1887, and in case the invitation was 
accepted, the committee was given full power to add to its mem- 
bership and perfect its organization as an executive committee ; 
to make all necessary arrangements for the meeting of the Con- 
gress, and to solicit funds for that purpose. 

This committee was composed of Austin Flint, Sr., New 
York; I. Minis Hays, Philadelphia; L. A. Sayre, New York; 



Editorial Department. 119 

C. Johnson, Baltimore; George Engelmann, St. Louis; J. M. 
Browne, U. S. N.; J. S. Billings, U. S. A., and H. F. Campbell, 
Georgia. The invitation was tendered and accepted, and in ac- 
cordance \vith the powers given it about twenty additional mem- 
bers were appointed and a general meeting held in Washington 
November 27th, 1884. At this meeting a plan of organization 
for the Congress was presented and adopted, also a system of 
rules taken from those governing the previous meetings of the 
Congress in Europe. Early in the present year these rules and 
lists of officers and- members of sections (nineteen in number) 
were printed in the yoiirnal of the American Medical jAssocia- 
tion, and also in pamphlet form. 

This report met with pretty general approval until the meet- 
ing of the American Medical Association in New Orleans in 
April, 1885, at which time Dr. J. S. Billings made a report of 
what had already been done. 

Then the trouble began. Dr. John V. Shoemaker protested 
against the acceptance of the report, stating, that the Amer- 
ican delegates at Copenhagen had been ignored at Copen 
hagen; that the committee had recognized the New Code and 
had made bargains with the New Code men. In this opposition 
to the report he was seconded by Dr. F. E. Daniel, of Texas; 
Dr. J. M. Keller, of Arkansas, and others, and the resolution was 
voted that the original committee be enlarged by the addition of 
one member from each State and Territory, also one each from 
the Army, Navy, Marine Hospital Service and the District of 
Columbia, and that this committee thus enlarged shall proceed 
to review, alter and amend the action of the present committee 
as it may deem best And by, a second resolution the whole 
committee (the original seven and the thirty-eight just appointed) 
was authorized and empowered to fill all vacancies that may oc- 
cur by death or inability to attend the committee meetings, and 
to appoint the officers of the Congress. 

The new members of the committee met in New Orleans 
immediately and elected Dr. Beverly Cole, of California, tempo- 
rary chairman, and Dr. John V. Shoemaker temporary secretary, 
and called a meeting of the whole committee to be held in Chi- 
cago June 24th. The chairman of the original committee of 
seven had already issued a call for a meeting of ihe whole com- 
mittee at Washington in September, but the temporary officers 



I20 The Peoria Medical Monthly. 

of the newly appointed annex had the majority and the Chicago 
meeting was held last week. About thirty members were pres- 
ent and the work of reyision undertaken. Practicalh' ignoring 
the organization of the original committee, Dr. R. B. Cole, of 
California, was elected chairman; Dr. J. S. Lynch, of Maryland, 
yice chairman, and Dr. John V. Shoemaker, of Pennsylyania, 
secretary. It was then resolyed that a sub-committee of nine be 
appointed to prepare a reyision of the rules and plan of the Ninth 
International Congress held at Copenhagen in 1884, for use at 
the Washington meeting of the Congress- in 1887. This sub- 
committee was composed of Drs. Scott, of Ohio; Wathen, Ken- 
tucky; BilHngs, U. S. A.; Hamilton, Marine Hospital Seryice; 
Upham, Vermont; Gouley, New York; McLaughlin, Texas; 
Linthicum, Arkansas, and Shoemaker, Pennsylyania. This sub- 
committee reported the next day that they had reduced the num- 
ber of sections to sixteen, and had made some changes in the list 
■of otBcers. The committee then adjourned to meet in St. Louis 
-in May, 1886. 

The principal changes made were as follows: Dr. E. W. 
Williams, of Ohio, Chairman of the Section on Ophthalmology, 
instead of Dr. H. D. Noyes, New York; Dr. J. N. Mackenzie, 
of Maryland, Laryngology, instead of G. M. Lefferts, of New 
York; Dr. J. Lewis Smith, New York, Diseases of Children, 
instead of Dr. A. Jacobi, New York. The members of the 
Council and other officers for the different sections haye not yet 
been announced. 

This brings the history up to the present time, and has been 
giyen according to the best authority we had, without prejudice. 
We now propose to giye some opinions of the medical press 
concerning the action of the American Medical Association. 

Seyeral reasons are giyen for the appointment of the addi- 
tional members of the original committee of seyen. 

ist. It is claimed that the officers and members of the coun- 
cils of the various sections were taken, almost exclusively, from 
a limited portion of the United States, and that many States and 
Territories were not represented at all. This aroused a strong 
sectional feeling, especialh' on the part Southern and Western 
delegates, who, by the wa}-, were in the majority at New Or- 
e ans. 



OUR CLAIMS FOR 



Mellin's food 



FOR 



INFANTSI^INVALIDS. 



MELLIN'S FOOD 

Is a soluble, dry extract from wheat and malt. 

MELLIN'S FOOD 

Is perfectly free from starch and cane sugar ; the starch being^ 
converted into dextrine and grape sugar. 

MELLIN'S FOOD 

Is entirely free from husks, indigestible inert matter, and animal 
germs. 

MELLIN'S FOOD 

Contains a large amount of proteids (albumoids) and soluble 
phosphates. 

MELLIN'S FOOD 

Is alkaline in reaction. 

MELLIN'S FOOD 

Is the only food which fulfils the requirements of Liebig's princi- 
ples ; it is prepared in accordance with the known laws of physiology. 

MELLIN'S FOOD, as an attenuant of cow's milk, furnishes needed 
carbo-hydrates, albuminoids, and phosphate salts ; it also adds alkali suf- 
ficient not only for permanent reaction, but also to convert caseine into 
soluble albuminoids, thus changing the properties of cow's milk and ren- 
dering it digestible by the infant. 



Doliber, Goodale & Co., 

Nos. 41 and 42 Central Wharf, Boston, Mass. 
/ 

Correspondence from Physicians promptly answered. 



NON-ALCOHOLIC. NON-RESIN^US 

BLAND AND UNIRRITATING. 

FLUID HYDRASTIS. 

A definite and permanent solution of the Alkaloids of Golden Seal Root, 
viz: 

B E R B E R I N A— Of a bright yeliow color, the salts of which are known in com- 
merce as Sulphate, Muriate and Phosphate Berberina (H5'drastia.) 

Hydrastia, crystallizing in ichite prismatic forms and insoluble in water. 

Xanthopucclna, or the unknown tliird alkaloid, of a dark yellow color, but 
which has never been carefully isolated, ahd is unknown in commerce. 

The use of Fluid Hydrastis is. suggested in all affections of the mucous sur- 
faces ; correcting abnormal conditions characterized by profuse discharge of tenacious 
mucous, subcute inflammation, erosions and superficial ulcerations. 



McDade^s Prescription 

FOR 

VENEREAL AND CUTANEOUS DISEASES. 



FORMULA. 

Fluid Ext. Smilax Sarsaparilla, 
Fluid Ext. Stillingia Sylvatica, 
Fluid Ext Lappa Minor, 

Flu d Ext Phytolacca Decandra, a a, two ounces. 
Tinct. Xanthoxyllura Carolinianum, one ounce. 
Mix— Take a teaspoonful in water three times a day before meals, and gradually 
Increase to tablespoonful doses. 

CAUTION. 

"In making the Fluid Extracts there is great risk of getting a remedy less efficient 
than the original Indian decoction, b^-cause the manufacturer may use roots that have 
been kept too long and lost some of their active principles; while the decoction used 
on the plantations was always made of Fresh Roots just gathered from the 
woods. In making the Fluid Extracts we should, therefore, be carelul to have them 
made from roots recently gathered." 

REMARKS. 

The Wm. H. Merrell CHEJiiCAn Co. of Cincinnati offer the formula of Dr. 
McDade, prepared in accordance with tie principles so strenuously held by them for 
more than tliirty years, viz . that the volatile elements of many plants are dissipated 
by the drying process, thereby injurihg, if not wholly destroying, their medical proper- 
ties. 

PRICE, $12.00 per Dozen. $1.25 per Pint. 



Green Plant and other Fluid Extracts.— Merrell. 

These remedies are positive Medicinal agents:— jjosiVu'c, not because they wl!l 
Invariably cure disease, but because their sensitive properties are definite, ntdformlsind 
cerUiin. Head for our paper on the subject of "Oreen Plant Fluid Extracts." 



Agents for Peoria and Central Illinois. 

SINGER & WHEELER, 1 
COLBURN, BIRKS & CO.. I p_ .. ... 
SUTLIFF, SHULTZ & CO. (' ^^^^^^* ^^^' 
ROBT. A. KING. 



Editorial Department. 121 

2d. It was claimed that the New Code was acknowledged 
by the appointment of well known New Code men. 

3d. It became apparent that Shoemaker of Philadelphia, 
Texas, Arkansas, and a few others had been ignored entirely. 

4th. It was claimed that certain schools, cliques and rings 
had too much influence, and that the solid conservative men of 
the profession were left out entirely. 

5th. It has been urged by some that the committee of seven 
exceeded their authority, ignored their responsibility to the body 
that appointed them, and should be taught a lesson. 

On the other hand, it is claimed by man}- leaders of med- 
ical opinion that the committee of seven did their work well. 

It is asserted that when the invitation was accepted at Co- 
penhagen, " it became de facto^ a committee not of the American 
Medical Association, but of the profession, deriving its existence 
from the International Congress, and no more responsible to the 
American Medical Association than to the American Academy 
of Medicine" — [dmada Med. and Surg. 'JoiirnaJ.') 

We believe the whole trouble has arisen from personal 
grounds on the part of a few who were overlooked when the 
places of honor were distributed. It was purely a fight of the 
" outs " against the " ins," and now that the " outs " have gained 
the field, the existence of the Congress is jeopardized. 

It cannot be claimed that the American Medical Association 
at New Orleans represented the medical profession of this coun- 
try, or if the claim be made it is a laughable one. And it cannot 
be denied that the American Medical Association, with ever}- 
similar body in the country, is more or less ruled by coteries and 
cliques. 

The situation is a deplorable one for the good name of the 
medical profession in America. Our European brethren will 
hesitate to attend the Congress at Washington in very large 
numbers, for they will have reason to fear that the factional feel- 
ing and jealousies of certain members of the " rule or ruin " 
party in the American Medical Association will carry their fight 
into the Congress itself. 

What is to be done to remed\' the trouble, and preserve the 
good name of the profession of America? W^e do not know; 
perhaps the best thing that could be done would be to notify the 



122 The Peoria Medical Monthly. 

Executive Committee of the last Congress that, owing to the war 
raging in the United States, the next Congress should be held 
elsewhere, either in Europe or Canada. 



MEDICAL OPINIONS. 

There will always be connected with laparotomy the inher- 
ited dread of opening that ominous peritoneal cavit3\ Modern 
surgery, however, is making steady progress in diminishing these 
dangers. Thus, the dread, as well as the safety of the patient, 
will, to a great extent, rest in, or depend upon, the care and skill 
of the operator. — D?-. C. Fenger. 

It seems to me very important in our present state of knowl- 
edge of new growths, that we should endeavor to construct clin- 
ical groups, selecting for that purpose cases which are really in 
their whole clinical history closely parallel to one another. His- 
tology is very helpful, but it cannot give us all that the surgeon 
requires for his guidance.- — 'Jonathan Hutchinson, F. R. S. 

An obscure practitioner who believes he has made a discov- 
ery, must keep writing and speaking about it until he gets a 
hearing, else the discovery will sink into oblivion, to be revived 
again by some one with the apostolic powers that the originator 
lacked.^ William Alexander, M. D. F. R. C. S. 

I am justified at least in hazarding the prophesy that the day 
is not in the distant future when the surgeon will resort to the 
same methods of treatment for wounds and diseases of the sin- 
uses and arteries of the brain as govern him in like or similar 
lesions of the trunk and extremities. — Dr. William M. Mastin. 

The idealist is generally a man of more dogmas than ideas. 
This class of people are a dangerous element in society. They 
believe a certain method, and then they get dangerous by start- 
ing out as reformers. An educated error, persistently followed 
up in practice, is productive of more danger to life, than a ju- 
dicious sort of ignorance, which is backward about meddling, or 
prescribes a placebo. — Dr. Romaine y. Curtiss. 

At the present time, and in the eyes of most communities, 
the plane to which the medical deponent and expert has at last 



Editorial Department. 123 



gravitated, is little above that of the ordinary if not the partisan 
witness. — Dr, Henry F. Camfbell. 

Treating a fracture is a simple mechanical probleni' capable 
of solution by any devise that will secure correct opposition and 
immobilization, while at the same time inflammatory conditions 
are prevented. — Dr. yohn B. Roberts. 

For independence of thought and originaHty in action the 
American doctor ha^ no equal, and many of the great advances 
in medical science may be attributed to the very fact that the 
code of ethics, as recognized to-day by American physicians, is 
the greatest protection they can possibly have, and gives them a 
stimulus that can be derived from no other source. — Editorial in 
Medical Herald. 

The profession at large on the Continent are far more intel- 
ligent as regards differences in climate and the composition and 
effects of the different mineral springs in Europe, than American 
physicians are of those of our own country. — Dr. Alfred L. 
1^00 mis. 

It is incumbent upon every surgeon to resort to laparotomy 
without delay when the diagnosis of vesical rupture is at all cer- 
tain. — Dr. Guterbock. 



WHO IS TO BLAME ? 

The gentlemen who incited all the trouble at New Orleans, 
arising from the report of the Committee on the International 
Congress, must feel rather cheap (unless their skins have been 
tanned by oleates to a thickness unfitted even for a shoemaker), 
for they have been roundly denounced by some of the leading 
journals in the country. " Ambitious agitators and turbulent 
schemers " they have been termed by the Medical Record, "Ag- 
itators and soreheads " by the JVezv York Medical journal. 
Even the highly conservative editor of the journal of the Amer- 
ican Medical Association considers " their zeal to be largely in 
excess of their wisdom." 



124 The Peoria Medical Monthly. 

Dr. John V. Shoemaker of Philadelphia started the matter 
in the New Orleans meeting, and he should be considered the 
leader of the schism. If the future history of the Congress shall 
show that praise belongs to him for his action, let him have the 
.praise, but if it should be developed that he made false state- 
ments (as charged by Dr. Jacobi, of New York); that he 
caused the trouble by his overweaning vanity and p,ersonal 
ambition (of which he has long been suspected); if it should 
prove to be true that he has been guilty of fraud in money mat- 
ters as charged by H. A. Merritt, of Tro}-, N. Y., and for which 
he was arrested and gave bail during his late visit to Chicago as 
member and one of officers of a committee of the American Med- 
ical Association, then Dr. Shoemaker should be relegated to a 
back seat in the Medical councils of the nation. 

Medical ethics should mean more than a refusal to meet a 
homceopathist in consultation, and the medical profession should 
demand that those who aspire to be leaders in medical ethics and 
high positions in the councils of regular medicine, must be men 
who are ethical in all things. 



DOCTOR AND DRUGGIST. 

We take the following from a letter to the Chicago Daily 
Tribune. It is the usual plea, but contains much truth, well ex- 
pressed: 

As to commissions paid to doctors b}^ druggists, it is only 
among the unprincipled of either profession that such practices 
are in vogue. No honorable physician or self-respecting drug- 
gist will ever sacrifice his liberty in that direction. But indi- 
rectly doctors levy tribute upon the druggist in the way of cigars, 
liquors, etc., and run up bills which they never intend to pay, and 
the druggist, through fear of offending a physician who does 
give him some business, does not dare ask for any payment. 
The family of such doctors also beat the apothecary out of soda- 
water, perfumery, etc., and the poor man can hardly get square 
by charging it on the public. Examine the books of any drug- 
gist and you will find accounts of this nature against physicians 
of more or less repute in his neighborhood — this is the way 
commissions are exacted. The people should beware of the 
drug-store loafer (so-called) physician. The eminent men of 
the profession have no time to compound medicines or loaf at 
the drug-store. Choose your druggist also as you would your 



Editorial DEPARTivtENt; 12^ 

physician — know his record and general character for probity 
and education. There is less danger of a mistake at a small 
store where the proprietor is constantly "on deck" than where 
many boys are at work. Druggist. 



DETROIT MEDICAL COLLEGE. 

We had intended writing our congratulations to the profes- 
sion on the union between the Detroit Medical College and 
the Michigan College of Medicine, and the consequent re- 
duction in the number of medical colleges, but later advices 
informs us that our labor would have been lost, as a " brand 
new " college is in process of organization, and the number of 
diploma mills will remain the same. The reasons probably are 
that some members of the old faculties have not been sufficiently 
recognized in the union, and that nothing but a new college will 
serve to " further their ambitious schemes." 



The remarkable improvement in the health of General 
Grant, in spite of the predictions af the doctors, is bringing 
stories of the M. D.'s to the front. One is told on a physician 
of this city who doctored a man for yellow jaundice for a week 
before he discovered that his peculiar sallowness was owing to 
the fact that he was a mulatto. Another is related of a young 
doctor who was called to visit a young lady who had been mar- 
ried about a year. Slowly and solemnly he felt the patient's 
pulse, and filled out a prescription. 

" But, doctor," observed an old lady who had been called 
in, "do you think you understand what is the matter with the 
young lady ?" 

" Oh, yes," said the young Galen, " I have been attending 
a man up Kickapoo Creek for month who has been down with 
the same disease." 

When, about an hour later, a bouncing boy was born, the 
doctor admitted that he had not properh^ diagnosed the disease. 
The "man up Kickapoo Creek" got well. — Peoria Transcript., 
yune 1st. 



V2S The Peoria Medical Monthly. 

if ..'; , ~ NOTES AND COMMENTS. 

j-; ' " "Df/'W! T. McLean, (Rush '81) Maroa, 111., was married 
June' 1 6th to Miss Margaret P. Crocker, of the same place. 
Congratulations are in order, and we tender our heartiest. 

Medical items are scarce this sumrner. We hope our read- 
ers will forward us any item 5 that will b2 of interest. 

A new rate of postage went into effect July ist; we waited 
for that date for it saves us several dollars in postage, even at one 

cent a pound. 

4 
We have been highly gratified with the reception of the im- 
proved Monthly. Every one writing has had a good word to 
say for and about it. We would be highly pleased to receive 
numerous short original articles, Mention the Monthly to your 
medical friends and induce them to subscribe for it. A good 
word won't cost you anything. 

William R. Warner & Co., of Philadelphia, received first 
premium for the great uniformity and solubility of their sugar 
coated pills. 

Peacock's Fucus Marina, prepared from seaweed, is claimed 
to be an antidote to malaria. Send for sample and mention this 
journal. See ad. 

RECEIPTS. 

The date following each name, indicates where the amount 
credited extends the subscription: 

Illinois —Drs. J. S. Bell (2.00) May, 1886; W. R. Baker (2.00) 
May, 1886; Jos. Studer, (2.00) May, 1886 ; G. L. Toel (5.00) May, 1886 ; 
Anna S. Adams (2.00) May, 1886; J. C. Frye (1.50) Aug., 1885; J. T. 
Stewart (2.00) May, 1886; C. A. iiowman (2.00) July, 1886; J. T. 
Taylor (4.00) :July, 1885; S. J. Bumstead (2.00) Sept., 1886; J. L. 
Brown (2.00) Nov., 1886; E. S. Adams (5.00) Dec, 1886; J. Homer 
Coulter (1.00) Nov. 1885 ; A. K. Van Horn (1.00) Nov.. 1885; C. T. F. 
Stringer (2.00) May, 1887 ; A. H. Kinnear (2.00) ; — L. G. Thompson 
(2 00) May, 1886; P. A. Ro.senberg, (2.00) June, 1886; W. F. Millen 
(2.00j May. 1886; T. H. Bras (2.00) Moy, 1886 ; O J. Roskoten (3.00) 
July, 1886; H. T. Hardy (8.00) Dec. 1^85. 

Iowa.— Dr.s. C S. Shopard (1.50) June, 1885 ; H. C. Hall (2.50) 
May, 1886 ; F. L. Hinsdale (2.00) Dec, 1885. 

WiH(;oNKiN.— Drs. C. W. Stoelting (1.00) July, 1885; R. L. Telfair 
(3.00) May 1886. 



. The Peoria 
MEDICAL MONTHLY. 



VoK V. MAY, 1884. No. L 



(fDrigittal (^ommuntation^. 



Akt I — Germ Origin of Disease as Seen by a Naturalist. By W. S. Newlon, 
M. D., Oswego, Kansas. 

There are other ways to determine the germ origin of 
disease besides the use of the microscope. If confined to 
this instrument there are many scientists and physicians 
on account of defective sight and other causes that would 
never be able to m?ike investigations in this interesting 
field or draw any correct inferences relating to it. Re- 
cently by the aid of the glass, however, rich discoveries 
have been made in microscopic germs causing disease, and 
we are to expect in the near future these discoveries will 
be enlarged and crystalized into usefulness and others, 
^rand and noble will be added to them. We are in danger 
at the same time of making this a rage and a pet, of im- 
puting too many of our maladies to these mysterious 
agents. We should when possible wait for positive facts in 
all mysterious matters of science before forming an opin- 
ion. But we cannot depend on the microscope m all diseases 
for facts. 

Some germs causing disease are so small, that nothing 
but the Divine Mind that formed them can see and estimate 
them. 

The power of the microscope in the near future may 
be so increased that we can look deeper and further into 



2 The Peoria Medical Monthly. 

the microscopic world. Beyond its vision, however, there 
will be noxious ^erins, no doubt, living, moving and having^ 
life no glass ever invented by humanity will reveal to us. 
How are we to suspect that such creatures, zoological and 
floral, do exist? Can we not say to almost a certainty 
they do exist in some cases by reasoning? If so, how? 

When a disease has a germ origin it presents to us in its- 
course some of the traits or phenomena of orgastic life, animal 
or floral. 

Let us name a few of those phenomena and then apply 
them to our common diseases: 

1st. Animals and plants are so nearly similar that what 
fact will apply to one applies to the other also. An Qgg of 
an animal and a seed of a plant are similar structures and 
the beginning of all organic life. After lite is originated 
in many cases it may be propagated by buds. To start life- 
from seeds and eggs they must be submitted to either 
germination or incubation and consequent fermentation. 

2nd. Germination or incubation puts in motion a force 
called fermentation or zymosis. No organic body can decay 
and rot without fermentation. Flesh, fruit and all organic 
bodies would never decay if millions pf germs did not in- 
cubate in every fibre and atom and set up fermentation and 
consequent decay. 

The tooth of oxygen may eat iron and nearly all metals- 
without germ life, but when organic bodies decay incuba- 
tion or germination starts the process. In some countries 
meat is elevated in the air above germ life and this saves 
it from putrefaction even when the days are hot. Fruit is 
sealed in cans not to keep out air but germ life. In any 
disease then tvhere there is putr if action and fermentation or 
zymosis there is abmidant germ life for a cause. 

3rd. There are floral and zoological zones around the 
earth running with the equator or parallels, and each zone 
has its peculiar flora and fauma. If the elephant and other 
phenomenal animals and plants live in such zones, micro- 
scopic animals and plants causing disease will do also. 

4th. Some plants and animals flourish in certain regions 
— in swamps, in valleys dark and cold — and some are ma- 



Original Communications. 3 

rine or aquatic and some inhabit sandy plains. When germs 
of this kind cause disease we call the malady endemic. 

5th. Animals can travel with the wind and against it. 
Plants are carried by streams and the wind and by animals^ 
and never against the wind. 

6th. Plants grow in the w^arm days of summer, rest in 
winter and with the spring revive again. Insects also live 
in the summer. 

7th. Animals may be entozoal and live in the dark, true 
parasites, but plants cannot flourish in the dark. Wood 
and Gray both say plants must have light for healthy growth. 
When plants cause disease we must suppose they grow on 
the surface of the body in the light. Animal germs may 
live anywhere in the body in the dark and in the light. 

Sth. Animals and plants are not attacked by parasites 
when in perfect health like w^hen they are sickly and weak. 

9th. Certain agents destroy organic life when applied 
to it. W^e call these agents antiseptics. 

Let us now try some of our common diseases by these 
traits or forms of organic life and see whether we can find 
any similarity. 

Tijyluis and Typhoid Fevers, have plantings and grow- 
ings. Zymotic, zoological zone for former. Antiseptics 
influence then. 

Small-Pox, Scarletina, Measles and other eruptions — 
Planting and hatching, travel against the wind, zymotic 
zones for some of them. Antiseptics influence. 

Whoojnng Cough and Mumps — Planted and incubation^ 
travel against the wind. Spread by germs. 

Ague and Intermittent Fever — Planted and germinate. 
Travel from sw^amps with wind, flourish in the summer^ 
rest in the winter, start up to life in the spring. Anti- 
septics influence. 

Goitre — Endermicto mountain valleys; aff'ectthe weaky 
is influenced by antiseptics. 

Consumption and Scrofula — Seem to grow after plant- 
ing; afllict the weak; have a zone; aftected by antiseptics; 
grow in the dark; seem to be animal germs causing them. 

Cancer and Lupus— lnQ.\ji\)?djQ(i and grow to maturity; 



4 The Peoria Medical Monthly. 

may be planted; seems to spread by pudding like protozans. 

Gonorrhoea and Syphilis — Planted seem to incubate and 
at maturity bear seeds or eggs; affected by antiseptics. 

Leprosy a?id Skin Diseases — Grow in the light; afflict 
the weak; spread to planting. * 

Hydrophobia, Snake Bite and Skunk Bite — Grow by 
planting; seem to be affected by antiseptics; zymotic. 

Eheumatism — Flourishes in damp weather; influenced 
by antiseptics. Said to be zymotic. 

Yellow-Fever — Has a zone; flourishes in warm weather 
like the plants and hexapods. 

Erysipelas, Influenza, Puerpural Fever, Typhoid Pneu- 
monia and Putrid Sore Throat — Spread by planting; affected 
by antiseptics; zymotic. 

The above observations were made in a great hurry in 
a busy life and are not claimed to be perfect by any means, 
but they open a new field for thought and study so far as 
I know. This is my apology. 



Abt. II. — Pneumonia. A paper read before the Peoria City Medical Association 
April 8, 1884, by Noble Holton, M. D., Smitliville, Illinois^ 

Pneumonia, pneumonitis, pneumonic inflammation, 
popularly called lung fever or inflammation of the lungs, 
is an inflammation of the vesicular structure of the lungs, 
often involving the cellular tissue and the minute bron- 
chioles contiguous to the air cells, and subsequently in- 
flammatory exudation into the air cells rendering them 
impervious to air. 

As it happens that in different cases of pneumonia a 
greater or less portion of the lungs is involved the disease 
is called by different names, as lobar pneumonia, lobular 
pneumonia. Also it occurs that on account of other de- 
rangements or conditions other names have been given as 
typhoid, bilious, gastric, tubercular, gouty, etc. And 
again a distinction as primary and secondary pneumonia. 

All these things should be known by the thorough 
practitioner and recognized when seen, yet in the limits of 
this unostentatious paper I thought of confining myself to 



Original Communications. 5 

the coDsideration of lobar and lobular pneumonia, as my 
desire is to make it of as much practical value as possible. 
Lobar pneumonia involves the greater part of one lobe or 
one lung, or sometimes of both lungs, and is the most com- 
mon, variety usually called catarrhal or croupal pneumonia. 
This attacks the patient suddenly, being ushered in with 
a chill of greater or less intensity and duration and imme- 
diately followed by fever, which in a short time attains 
great intensity. There is pain in the affected side, dys- 
pnoea, cough with clear tenacious sputa, which subse- 
quently becomes rusty. This disease has been divided into 
three stages, viz : First — Inflammation. Second — Exuda- 
tion, or red hepatization. Third — Softening or degenera- 
tive, called gray hepatization. 

Each of these stages in some cases have dangerous 
symptoms. In the first if a large part of the lungs is in- 
volved and the pressure of the alveoli by the overdistended 
•capillaries surrounding them severe, the entrance of air 
into the air cells is so far prevented as to greatly hinder 
the decarbonization and oxygenation of the blood. All the 
effects of carbon retained in the circulation will rapidly 
ensue, shown by the hurried, panting respiration, feeble, 
unsteady pulse, the heart beating excitedly at first, soon 
showing signs of weakness, venous congestion of the neck 
and chest, cyanosis, collapse and death. The danger in the 
■second stage is from the inflammatory exudation into the 
lung tissue and air cells. This exudate is derived from the 
elements of the blood and will amount to from one to three 
pounds in different cases, and in effect is about equivalent 
to venesection to that extent. This condition also, like the 
first, hinders the access of air to the lungs (alveoli) and as 
a matter of course the oxygenation and decarbonization of 
the blood. The result of so large an amount of blood ele- 
ments lost from the circulation and its consolidation in 
and around the alveoli, you will readily see must produce 
a profound sedative and depressing effect upon the heart's 
force and respiration. This to me would constitute the 
danger in the second stage, and which in severe cases may 
Tesult fatally. 



6 The Peoria Medical Monthly. 

Third stage, or that of degeneration or suppuration, i& 
dangerous on account of the drain upon the constitution 
from that cause. Where the extent of lung tissue involved 
was large in the first stage, and the exudation correspond- 
ingly large, the drain upon the system may continue till a 
fatal result is reached. 

Diagnosis — The lungs are found in that part of the 
body called the thorax, and their function is that of respi- 
ration, which is accompanied with sounds, and in health 
those sounds are called normal. To be well prepared to 
detect disease in the lungs the normal sounds should first 
be perfectly familiar and then any deviation will at once 
be noticed. Various methods of making examinations of 
the lungs are used, such as inspection, palpation, mensur- 
ation, succussion, percussion and auscultation, but of these 
the two latter are principally depended upon. Some cases 
are so obscure as to require all the means of diagnosis to 
make them clear, while generally percussion and ausculta- 
tion will be sufficient, but by all means use enough to make 
a clear diagnosis. 

For the purpose of definite results from the physical 
examination of the lungs the surface of the chest (thorax) 
has been mapped out in divisions, as on the anterior part 
the infra-clavicular, supra and clavicular regions, mam- 
mary and infra-mammary, upper and lower sternal regions. 
The posterior surface of the thorax is sub-divided into the 
supra-scapular, scapular and intra and infra-scapular. Lat- 
erally are the axillary and infra-axillary regions. 

In some of these spaces we do not get the respiratory 
murmur and consequently will not get the rales or crepitus 
of pneumonia, and on account of misapprehension in this 
regard by some members of the profession with whom I 
have been associated in the examination of patients, I will 
be particular in defining the boundaries of the resonance 
of the lungs. In the supra-clavicular just above the clav- 
icle is the apex of the lungs on either side and respiratory 
murmur. 

In the clavicular and infra-clavicular region is lung 
tissue on each side, but in the infra-clavicular region close 



Original Communications. 7 

to the sternum od the right side we find the ascending 
aorta and descending vena cava and the right bronchus. 
On the left side the pulmonary artery and the left 
bronchus. 

The mammary region just below the above from the 
lower margin of the third rib to the lower margin of the 
sixth rib, contains lung tissue on both sides. On the right 
side the lower margin of the lung overlaps the liver, and 
on this account commencing dullness which on deep per- 
cussion extends to the upper margin of the fifth rib. 
Close to the sternum a part of the right auricle and ven- 
tricle are found. On the left side next the sternum be- 
tween the fourth and fifth rib the heart and investments 
are located. The infra-mammary region just below the 
latter on the right side contains the liver, and we get flat- 
ness on percussion. On the left side next the sternum the 
liver, further to the left the stomach and spleen, the twO' 
latter extending to the sixth rib. In the upper sternal re- 
gions we find lung tissue on both sides of the median line. 
In the sternal region we find the heart with its valves — 
the valves being so close together that they may be covered 
by a circle one and one-fourth inches in diameter. Below 
we have the liver and other organs mentioned while de- 
scribing the infra-mammary region. The axillary region 
down the axillary space along the side and contains lung 
tissue on both sides of the body. 

Posteriorly resonance is not distinct over the scapula 
on account of the density of the tissues intervening, but 
in the intra and infra-scapular regions more distinct. 

Presuming the sounds of respiration in health and the 
location of the lungs and other thoracic organs are now 
understood we will see what abnormal sounds indicate 
pneumonia. Suppose a patient is seen within a few hours 
after the subsidence of the chill and before the stage of 
full inflammation, inspection shows diminished movement 
of the afl'ected side, palpation nothing, percussion dimin- 
ished, respiratory resonance, and later dullness, increasing 
as the disease advances. Auscultation shows feeble respir- 
atory murmur aad later numerous fine crepitant rales. The 



8 The Peoria Medical Monthly. 

latter determines the case to be one of pneumonia. In the 
exudative or second stage inspection shows deficient move- 
ment of the affected side and palpation exaggerated vocal 
fremitus. 

Percussion shows dullness extending as far as the lung 
is affected, No crepitant rales but some dry and bronchial 
rales and sub-mucous bronchus with increased respiratory- 
resonance on sound side. In the third stage subcrepitant 
rales and later broncho-vesicular breathing, and finally as 
resolution is completed normal respiratory murmur. 

It is important that the disease in its differential diag- 
nosis be not mistaken for pleurodynia, intercostal neural- 
gia, pleurisy, pulmonary oedema, collapse of the air vesicles, 
hydrothorax, phthisis, and bronchitis, but the limits of this 
paper will not permit the specific signs of each of these 
diseases, 

TREATMENT. 

In the treatment of pneumonia if the propositions laid 
down are correct it would be desirable in the first stage to 
so far control the febrile reaction as to limit the inflam- 
matory and exudative processes of the second stage. The 
means used for this purpose are venesection and sedatives. 
If the case is one of full habit, without other conditions 
or derangements and the whole of one lung or a consider- 
able part of both lungs is involved and the patient is seen 
within twenty-four hours after the attack, bleeding would 
be urgently required. This followed by opium and quinine 
in full doses and accompanied by some sedative as verat- 
rum viride or tincture of aconite, would be good treat- 
ment in this stage. 

Also I have for many years used a jacket poultice of 
linseed meal on the chest, or as a substitute silk oilcloth, 
and especially in children, with great apparent benefit. In 
a moderate case and in the first ten or twelve hours after 
the attack, a blister over the part diseased, together with 
the use of a full dose of quinine and dover powder will 
abort the disease entirely. In some cases when seen in the 
early part of the disease the use of fluid extract of ergot 
and bromide of potassium in full doses and repeated will 



Original Communications. 9 

act very desirably. Bleeding nor sedatives should be used 
after the exudation takes place, but tonics and expector- 
ants. In the third stage strychnia, carbonate of ammo- 
nium, quinine and digitalis with counter irritation, will be 
useful. The congestive conditions of the lungs sometimes 
seen in typhoid fever and in other low forms of fever and 
in measles, may be best controlled by the use of fluid ex- 
tract of ergot. In cases of pneumonia, where the patient 
, has been exposed to malarial influences, or has had malarial 
fever the fall before, will probably need nothing but the 
free use of quinine. 

LOBULAR PNEUMONIA. 

This kind of pneumonia is mostly confined to chil- 
dren, but sometimes attacks aged people. Generally it is 
preceded by bronchitis and then a lobule or several lobules 
become inflamed, and in children in some cases a large por- 
tion of the lobules of the lungs and of the bronchioles be- 
come involved, making what is sometimes called bronchial 
or interstitial pneumonia — a very dangerous disease. A.ny 
part of the lungs may be involved by this disease, and the 
nodules are from the size of a millet seed to a walnut. It 
is accompanied with a rapid ^"pulse and respiration and a 
very high temperature. The respiratory movements are 
lessened, a patchy dullness on percussion and vesicular mur- 
mur on auscultation. If the disease is very limited a diag- 
nosis is scarcely possible. The treatment should be tonic, 
as sedatives are inadmissible. Quinine, carbonate of am- 
monium and iodide of ammonium are useful, together 
with stimulants and stimulant expectorants. In the later 
stages counter-irritants and stimulant inhalations are ben- 
ficial. 

GENERAL REMARKS. 

My impression is that venesection in pneumonia has 
not been practiced in twenty-five years, but very seldom 
and only by a small minority of the profession, and I do 
feel sure that I had a case about thirty years ago that died 
without bleeding that might have lived if he had been bled 
at the right time and to the proper extent. The percent- 
age of this kind of cases is not large in this malarious re- 



10 The Peoria Medical Monthly. 

gion of country, just how large I cannot say, but let me 
say here that it is not good medical philosophy to discard 
so potent a remedy. Make the diagnosis and then consider 
all the influences that have any bearing upon the case, and 
finally adapt the treatment to each individual patient. 



Art. IIL— Treatiiieiit of Fractures of the Skull. A Paper Read before the 
Peoria 3Iedieal Association, Tuesday, April 23, 1883. By J. T. Stewart, 
M. D., Peoria, Illinois. 

The importance of this subject cannot be readily over- 
estimated. No other fractures bear any comparison unless 
it may be those of the spine. The far-reaching consequen- 
ces, the dreadful effects which are liable to result, even 
after years of comparative health, throw a fearful respon- 
sibility on the surgeon. If it were only a matter of life 
and death it would not be so bad. An error of judgment 
leading to an error in practice, may, and is, very apt to en- 
tail a life of misery. Epilepsy, insanity, idiocy, any of 
which is more to be dreaded than death. 

The treatment of these fractures was pretty well es- 
tablished by the older surgeons, and there was a fair de- 
gree of unanimity in the profession, but of late a portion 
of our surgeons have drifted away from the sound teach- 
ings of the fathers in surgery. These teachings were es- 
tablished, were the results of much observation and long 
experience of the finest surgeons the world ever produced. 

The improvements in this case is like many of our 
modern improvements, in the wrong direction. 

These fractures may be any form or size. They may 
be simple, compound or comminuted. In any of them in 
case there is no depression of bone immediate operative 
measures are uncalled for and wrong, but if symptoms of 
compression of the brain come on and is at all persistent, 
then trephining becomes necessary, for that is pretty sure 
evidence of depression of the inner table, or at least of 
effusion on the dura mater, which would be relieved by 
the operation. 

In all cases where there is any considerable depression, 
whether it be a simple or compound fracture, whether there 



Original Communications. 11 

are any symptoms of compression of the brain or not, the 
only true practice is to elevate the depressed bone. It 
was to call attention to this most important thing and ob- 
tain the views of the members I brought this subject to 
your notice to-night. There are many points of interest 
which we might discuss with profit for hours, but this is 
the great overshading practical question. When we are 
called to attend a fractured skull shall we trephine or not ? 
It is interesting and important to study the various kinds 
of fractures, the relative danger in the different regions, 
etc., but compared with the vital question in a certain case, 
shall we elevate the depressed bone or trust the case to 
nature, as some advise. They are of little importance. I 
admit I was led to believe the conservative plan was 
best in almost all cases, and practiced it ; but gentlemen I 
have seen enough of the results of this practice to con- 
vince me it was a tatal error. I have yet to see the first 
man who had any considerable depression which was not 
corrected at the time, who, ten years after, did not suffer 
serious trouble from it, and some of them have become 
such wrecks it would have been a mercy to them and their 
friends if they had died when first injured. I know the 
line of duty is not always clear. There are cases which 
will perplex the wisest and most experienced surgeons. I 
would rather err on the side of trephining when it is not 
necessary than to fail to trephine in any case in which time 
afterwards revealed the fact that it ought to have been 
done. , You may say in these cases, trephine then. After a 
few months or years have passed the bones become solid 
and it is rare that the operation will then do any good. If 
there should be a spicula of bone growing down into the 
brain and you can strike it and remove it the operation 
would be a success, but they are the exceptional cases 
where this can be done. 

The operation itself, if properly done, is not a very 
dangerous one, and then again there are many cases where 
Hay's saw can be used so as to make an opening large 
enough to admit an elevator. 

Gentlemen, the dangers of this operation have been 
exaggerated and the value of it has been underrated. 



12 The Peoeia Medical Monthly. 

0nr (Slittwal 3^cxtt^, 



[For this department we hope to enlist the co-operation of our friends. Short reports of 
interesting eases are especially requested from every one. We would like to liave twenty or 
more such articles for each number. See editorial in No. 1, Vol. V, May, 1884.] 

Art. IY. — Pi-olapse of the Bladder. By J. F. Cokbett, Weyauwega, "Wis. 

Mrs. K., 28 years of age, had previously given birth to 
two children. I was summoned hastily to attend her in 
her third confinement ; found her suffering excruciating 
pain and a dragging sensation, directed most especially to 
the navel, and frequent propulsive efforts to expel the 
urine. She had suffered more or less for the past twelve 
hours, but now the suffering was intense. 

On examination I found a large round fluctuating mass 
protruding beyond the labia, which at first I supposed to be 
the sac of unruptured membranes, but the attendent had 
informed me that the membranes were already ruptured. 

On making a more thorough examination, I found the 
OS well dilated and the presenting head well down in the 
pelvic brim, and that the mass originated from the anterior 
wall of the vagina. 

I then, with considerable difficulty, introduced a flexi- 
ble catheter almost downward into the tumor ; then by 
pressing the presenting head well back, and by careful 
manipulation, I succeeded in replacing the prolapsed or- 
gan, and labor came right along without any further signs 
of displacement. 

I drew off about a pint of urine at the time, and con- 
tinued the use of the catheter twice daily for about a week 
subsequent to delivery, and then I instructed the patient 
to void urine for a time while resting on her hands and 
knees, and' to use as little propulsive effort as possible. 

She made a good recovery and had no further trouble. 

There had been no previous trouble with the bladder, 
neither was there nor had there been any laceration of the 
vesico vaginal septum or perineum. 



Akt. v.— Vomiting of Pregnancy Relieved by Pop-Corn. By E. Newton 
Campbell, M. D., Good Hope, 111. 

Mrs. W., 20 years old, has been married two years. 
Menstruated the 15th of February, 1884. About the 24th 



Our Clinical Society. 13". 

of March she began to suffer from slight nausea, especially 
of mornings. I was consulted at this time as to the cause 
of such nausea and unpleasant manifestations, etc. Being 
assured she was pregnant, both husband and wife were 
pleasantly reconciled to the situation of things, it being, 
the first time she had ever been pregnant. 

Prescribed R. — Bismuth, subnit., 1 drachm. 

Pepsinae saacb, 3^ drachm. 

Cerii oxalat, 10 grains. 

M. In Chart. No. vi., Div. et. Sig. One every 3 hours. 

Nothing unusual occurred until the 10th of April, 
when she was taken with persistent vomiting. I repeated 
the above prescription with no success. In fact, to make 
a long story short, I proceeded to treat her in the orthodox 
way, until all the remedies, local or otherwise, were ex- 
hausted, nourishing the patient per rectum for a week, 
when the bowel became so irritable that further attempts 
in that direction were discontinued, the patient having be- 
come very weak from the excessive vomiting and loss ot 
sleep. Having seen but little to encourage the use of pop- 
corn, and not much faith in it anyway, I indifferently in- 
structed the discouraged patient to use what she could ot 
it until the next day, when my friend Dr. Harrison, of 
Bushnell, 111., would visit her with me. Accordingly the 
following day we saw the patient as agreed upon, and to 
my surprise found her better. She said she had passed 
rather a comfortable night and was in hopeful spirits. The 
pop-corn was continued and the result was almost magicaL 
The nausea and vomiting ceased immediately, and in a few 
days the patient could sit up, and soon began to take food 
pretty regularly, no return of any unpleasant symptoms 
up to this time. The corn should be well popped and the 
stomach filled to repletion. Gentlemen, try pop-corn and 
report results. 



Aet. VI.— Vesico- Vaginal Fistula— Operation— Cure. By O. B. Will, M. D.*^ 

Peoria, 111. 

Mrs. C, aged 29 years, a native of Ireland, was admit- 
ted to Cottage Hospital March 12, 1884. She had been 
married eleven years, and given birth to six children, the 



14 The Peoria Medical Monthly. 

last a boy and still-born over a year previous to admission. 
She had always before had an easy time, but at the last la- 
bor was sick about twenty hours, though not bad. The 
child was somewhat larger than the others, but did not 
know its exact weight. On account of the illness of her 
family physician she saw fit to employ a midwife. The 
presentation was vertex, as all the others had been. Pains 
came on about 5 o'clock in the morning and were only 
moderately severe until 11 p. m., at which time the midwife 
used a shawl pin, as she stated at the time, to rupture the 
bag of waters, and in a couple of hours the child was born. 
Shortly after her labor the patient discovered an inability 
to retain her urine, and when able to go out consulted her 
family physician, who, surmising the nature of the case, 
referred her to me. 

Examination revealed an absence of the anterior lip 
or half of the cervix uteri, to the extent of an inch or 
more, with the exception of a small pedunculated, tit-like 
portion, the whole evidentlj^ having sloughed away, carry- 
ing with it a portion of the vaginal wall and base of the 
bladder, producing a vesico-vaginal fistula. 

The opening was a triangular one, immediately in con- 
tact with the cervical stump, and connected with the latter 
more directly by one of its angles, and to the left. It was 
large enough to readily admit the index finger. A par- 
tially cicatricial fold of the vaginal mucous membrane, ex- 
tending from the lower angle of the fistula to the middle 
of the cervical stump, after being rendered less tense by 
partial severance from its superior attachment, lay some- 
what like a flap over the opening. 

An operation for its obliteration having been deter- 
mined upon, the patient was etherized and placed on the 
operating table in the Simon's position, a roll of blanket 
being placed under the hips and the thighs well flexed upon 
the abdomen. Assistants holding the vagina well open 
with Sim's speculum and other retractors, I first snipped 
off the tit-like remaining portion of the anterior lip of the 
cervix uteri, and then proceeded to operate upon the fistula 
proper. With a tenaculum I caught up the flap-like por- 



Our Clinical Society. 15 

tiou of the vaginal fold projecting over the opening, and, 
after snipping its uterine attachment to such an extent as to 
make it less tense and approximate more closely the oppo- 
site side of the opening. I pared its vesical surface with 
the long-handled sharp pointed scissors to the extent of one- 
quarter to three-eighths of an inch. Then, catching up the 
free vesical margin of the opposite or right side of the 
fistula, I in the same manner pared to the same extent 
its vaginal surface. A very slender needle, curved at the 
point and armed with silk was then introduced into what 
might appropriately be called the vaginal flap, at a point 
directly opposite the limit of its denudation, coming out at 
the latter, re-introduced as near as possible to the free 
margin of what might wth equal propriety be called the 
vesical flap, and finally brought out about one-quarter of 
an inch beyond the vaginal limit of the denuded surface of 
the latter. The mucous membrane of the bladder was not 
transfixed. Half a dozen stitches were thus passed, num- 
ber 29 wire being pulled through by their aid, simply 
twisted, cut off at less than half an inch from the vaginal 
surface, and with the forceps bent down upon it. At the 
time of adjustment a sound was kept in the canal of the 
cervix to prevent the possibility of turning the latter into 
the bladder. 

The patient was kept on a light diet, the bowels open, 
the vagina washed out with carbolized 'water, and the 
catheter retained for forty-eight hours, after which time, 
in consequence of irritation of the urethra it was with- 
drawn and re-introduced very carefully every two hours 
thereafter, day and night, for ten days, by the very efficient 
hospital matron, Miss Lucy Taylor. On the twelfth day 
the stitches were removed with some difficulty and slight 
bleeding, and union found to be entire. The bladder was 
filled with water and found to retain it perfectly. The ex- 
coriations of the vagina, vulva, buttocks and limbs, result- 
ing from the dribbling of urine, had entirely disappeared 
and on April 16 the patient was discharged cured. 

Note — In connection with the history of the above case 
is an interesting question, viz : What occasioned the ex- 



16 Thb Peoria Medical Monthly. 

tensive sloughing ot tissue following the birth of the child? 
From the woman's own account of the case it would seem 
that she had as little suffering as at any previous labor, ex- 
cept that involved in an extension of the time ; that the 
membranes were not ruptured until very shortly before de- 
livery, and that the latter was then rapid. Did the use of 
the shawl-pin cut any figure as an etiological agent? It is 
hard to understand how it could. 



Art. VII. — Retained Placenta and Embryo. By J. B. Shoemaker, M. D., 
Columbia City, Oregon. 

In all of my experience it has never fallen my lot to 
treat a case similar to the one I will briefly delineate in 
this paper. 

On January 6th last I was hastily called to attend Mrs. 
P., aged 26 years, the mother of one child, aged 4 years. 
Previous to the present date the lady miscarried once^ 
April 15, 1883, but had very fair health through the inter- 
vening months. She stated to me that at her confinement 
and miscarriage she was able to leave her bed in ten days 
and resume her household duties. By questioning her hus- 
band on my way to his home and the lady on my arrival^ 
I found that mischief had been done, but how remains a 
mystery yet to me. Husband and wife tell different stories 
as regards the origin of her said condition, she telling 
me she wanted no more children because of trivial family 
troubles made me a little suspicious, but when I questioned 
her closely she "said that she danced a few nights ago and 
supposed it and her husband's ill-treatment the cause of 
her precarious condition." I turned a deaf ear to all stories 
on both sides and proceeded to make examination of the 
OS uteri and surrounding parts to find the conditions of 
matters, because I had, as I looked at it, but very little to 
base my diagnosis and treatment as well as prognosis on; 
but careful investigation and study, with questions to the 
lady she could not help answering correctly, I soon found 
out all I desired to begin my duty as a practitioner. I found 
considerable hemorrhage and regular contractions of the 



Our Clinical Society. 17 

uterus, and she told me things had been so for two days 
previous. On digital examination I found the os dilated 
for the admittance of my finger and soft and in a condition 
to dilate sufficiently for the free passage of foetus at full 
term. After I had finished my examination I told her it 
was impossible to prevent miscarriage as the contents were 
destroyed, and at the third month could not be retained by 
any means. But I told her I must try to prevent it because 
we have hopes until we see we can do nothing but remove 
it, but she shuddered at the proposed proposition, never- 
theless I put up several powders of Dover's powders 
of ten grains each, given every three hours in combination 
with a thickly folded flannel cloth wrung from hot water 
applied over the entire womb, joined with absolute rest 
and liquid food, till I came next day. 

January 7, 8 a. m. — Condition unchanged except con- 
tractions were somewhat under control. Pulse 110, weak 
and very irregular. Temperature 99 degrees. Had but lit- 
tle desire for food. Rested very well during the night. 
When I examined the medicine I found it had not been 
taken as directed, she knowing it had a tendency to pre- 
vent the mischief she was so anxious to be obtained. 
Hemorrhage unchanged. Had a tendency to vomiting. I 
put a drachm of bismuth subnitrate, carbolic acid, minims 
ten, in one ounce of water, to be given in ten doses, as 
needed, to check the tendency. 

January 7, 4 p. m. — Found it impossible to do anything 
to prevent miscarriage, so I checked all preventatives and 
in one hour gave one drachm ext. ergot fl., repeated one- 
half the same quantity in thirty minutes. But I found to 
my chagrin that the ergot checked instead of increasing 
the powers of the uterus. So something else must be 
given, and I put up one grain doses of permanganate of 
potassium, to be given every three hours till the contents 
were removed. I had another call needing my immediate 
attention and left everything with a nurse, directing her to 
save the contents when passed and to have me called if any 
danger from hemorrhage she could not control. At 6 p. m. 
I left, leaving the pulse 120 and weak, as she had lost con- 



18 The Peoria Medical Monthly. 

siderable blood. Temperature 100| degrees. No desire for 
food and no tendency to vomit. 

January 8, 9 a. m. — When 1 entered the room the patient 
says, "I guess all is right now; ail is over." I asked the 
nurse what she did with the contents. She said she " threw 
them away." Her and nurse were confident that all wa& 
over, but I was not satisfied, as the temperature was still 
100^ degrees, and the pulse 125, and appetite poor. I took 
the words ot the experienced nurse and patient as true^ 
but put up the following prescription: 

B Salicylate Soda 30 grains. 

Dovers Powder 10 grains. 

C Rhubarb Pul 5 grains. 

Capsicum i^ grain. 

Misce et Signa. Divide into ten powders and give one 
every three hours to regulate the temperature and prevent 
blood poisoning. Fever drops were administered in con- 
junction with the above. So I left medicine in the care of 
the nurse and expected all to go right until I called again. 

January 9, 8 a. m. — I visited her again and found her 
not improving as she should. She complained of pains in 
the back and thighs and a bearing down sensation in the 
womb, with a very fetid discharge instead of the previous, 
blood. I made an examination and found the os tumified 
and indicating an inflammatory process in the uterus. I 
ordered carbolized warm water thrown against the os for 
several minutes as often as four or six times daily, the 
woman in the recumbent position, bed and bedding being 
protected by oil cloths, &c. I began to feel suspicious of re- 
tention of the contents, but an examination I deemed in- 
jurious to her in the condition she was in. All I did was 
to increase the dose of the above prescription to prevent 
septicaemia, as there were indications of future danger. 
Temperature unchanged. Pulse 108. Had some appetite. 
I ordered tea, animal broths, milks, etc., in liquid forms at 
all times. I began the administration of brandy, in tea- 
spoonful doses every three hours. Rested very well through 
the night. 

January 10, 9 a. m. — 1 found very little change, gen- 



Our Clinical Society. 19 

erally speaking, but the discharge was increased and the 
consistency of cream but very offensive, nevertheless using 
the injections of carbolized water frequently. A little more 
restlessness and sleeple3sness during the night. Tempera- 
ture and pulse unchanged. No vomiting, and relished food 
with steadily increasing appetite. Line of treatment un- 
changed 'till I made the next visit. 

January 11, 4 p. m. — Was sent for to come down as 
something had been thrown off. I went and found the en- 
tire contents en masse so changed I could scarcely discover 
the different portions. The mass plainly showed it to be 
of three months development. Several putrefied clots of 
blood, covered with creamy pus, were discharged at same 
time. The temperature was 101| degrees. Pulse feeble 
and quick, but fair appetite. Continued the medicine same 
as before, except adding a mixture of potassium bromide 
and hydrate chloral, equal parts, to obtain rest and sleep, 
for there existed an increasing degree of restlessness and 
sleeplessness. 

January 12, 4 p. m. — I found the patient much better in 
every respect and the discharge diminishing in quantity 
and offensiveness. Less restlessness and good appetite at 
this date, and I allowed her to be propped up in bed. Tem- 
perature 99| degrees. Pulse 100, and stronger and more 
regular. Pain in backs and limbs fast disappearing, and 
only a little soreness remaining to indicate what had oc- 
curred. From this period she gradually improved until 
now she has better health than for several years. She was 
able to do housework in four weeks from her first illness. 
But strange why so many will criminally do themselves 
an embryo injury sufficient to destroy the contents of the 
uterus. Dear doctors, all of you who read this, will prob- 
ably bring to mind similar cases, but be careful (as I should , 
have been) to have the contents saved, for then you caa 
tell what you are doing. If they are destroyed, if passed 
in your absence and relying too much on what some one 
else tells you, it will be a detriment to you for life. I worked 
through this case and am blamed by every one, because 
it is a known fact that she did something to miscarry both 



20 The Peoria Medical Monthly. 

times. Uncalled for embryoctomy is injuring thousands of 
women, and not unfrequently the true cause of their death. 
Doctors, as well as women themselves, perform the work 
seemingly, thoughtless of the crime. I will close, for my 
article is long enough, but many important features are 
left unpenned in regard to the case for want of space and 
.time. 



Art. VIII. — Retention of a Glass Pessary in the Vagina for T\renty-one Years. 
By Robert BoATi, M. D, Peoria, 111. 

From time to time the joiirnals record cases of the re- 
tention of pessaries in the vagina for many years, with the 
accompanying untoward results. As an addition to the 
number the following case may be of interest to your 
readers. On the 7th of last month I was called to see Mrs. 
v., a German woman 61 years of age, residing in the 
southwest portion of the city. Upon inquiry I learned 
that she had been sick for 7 or 8 days. She complained of 
pain in the epegastrium and over the whole abdomen, with 
great tenderness upon pressure. Vomiting, with marked 
tympanitis over stomach and intestines. Pulse 95. Tem- 
perature 99.3 degrees. Tongue, red, smooth and slightly 
dry. In the right iliac region a hard tumor was discovered, 
probably the result of faecal accumulation. 

On the fourth day of my attendance she informed me 
that she wore a pessary for prolapsus uteri. Upon further 
inquiry I learned that when she was 40 years of age, soon 
-after the birth of her last child, a physician in Philadelphia 
introduced a pessary, which she had worn continuously 
without removal during a period of 21 years, and, as she 
averred, without inconvenience or discomfort. Thinking 
the presence of the pessary might aggravate her condition, 
I decided to remove it. On making an examination, I found 
the upper portion of the vagina completely filled by a large, 
solid pessary, which was apparently firmly fixed and em- 
beded in its walls. After some manipulation I succeeded 
in turning it edgewise and endeavored to extract it by in- 
serting my finger in the opening in its centre. T found I 
could not accomplish the extraction with my finger alone, 



Our Clinical Society. 21 

I therefore improvised a hook from a piece of strong wire 
which I found in the house, and after patient and moderate 
traction with the hook and finger combined, succeeded in 
removing a glass disc pessary, from 2J to 2i inches in diam- 
eter, one of the kind in use 20 or 30 years ago. A shallow 
sulcus was found in the posterior wall of the vagina where 
the instrument had rested so long. Apart from the length 
ot time this large pessary occupied the vagina, the interest 
of this case centres in the fact that it was worn for so 
many years without local lesion or constitutional disturb- 
ance, as the patient reported that neither difficulty in uri- 
nation nor defecation had ever occurred. She had never 
suffered from vaginitis, nor had there been at any time an 
excessive leucorrhoeal discharge. No incrustations were at- 
tached to the pessary. It was as smooth as though it had 
been just introduced, w^hich may have been owing to her 
habit of using daily vaginal injections of water, which she 
informed me she never neglected. Subsequent examinations 
after the removal of the pessary revealed no heat, tender- 
ness, or any other diseased condition of the rectum or va- 
gina, consequently it did not form the initial point of 
lesion from which the peritoneal inflammation was propa- 
gated and of which she subsequently died. 



Art. IX. — Painless Labor. A case reported by J. S. Miller, M. D., Peoria, 
Illinois. 

I am impelled to report the following rather unique 
■case of labor, because of its rarity and interest. A case of 
similar character has never occurred in my practice before, 
neither have I read of a case where labor progressed from 
beginning to end without more or less pain. I am aware 
some of the authorities mention painless contraction of the 
uterus. This, however, is the first case 1 have ever observed. 

March 8, 1884, I was requested to see Mrs. S , aet. 

38, whom I had been engaged to attend. Time of expected 
€onfinement, April 1. The patient, a strong, robust lady of 
fine physique, is the mother of four children. In May, 1883, 
she miscarried at tour months without assignable cause. 



22 The Peoria Medical Monthly. 

Her previous labors were not attended with unusual cir- 
cumstances. When I arrived at her residence (7 a. m.,) 
found her agitated, despondent, and extremely nervous. 
She informed me nothing had transpired to account for thi& 
condition; that she retired the previous evening feeling 
quite as well as usual, and had slept well until about 2 a. m.^ 
when she awoke suddenly, feeling very nervous, and had 
been unable to sleep since. She did not present any of the 
symptoms of uraBmic intoxication, and an examination of 
the urine negatived albuminuria. She had had no pain^ 
discharge, or other symptoms of approaching labor. At- 
tributing as a cause for her agitation a sense of impending 
danger as her accouchement drew near, was about to pre- 
scribe a sedative. Before doing so, however, I suggested 
the propriety of an examination, to which she assented. 
Upon introducing my finger, I found theos dilated to nearly 
its full extent, with the membrane protruding and unrup- 
tured. Vertex presentation, occipito anterior, left. I rup- 
tured the membrane, when the head descended to the 
inferior strait. Informed my patient she was in labor, and 
that it would soon terminate, but having borne children, 
she seemed inclined to doubt what I told her. She now 
became composed and cheerful, and informed me I might 
as well go home. I made friction over the fundus uninter- 
ruptedly for half an hour, hoping to stimulate uterine con- 
traction. Failing, administered half teaspoonful of Squibbs'' 
fluid extract of ergot, with no better success. I continued 
abdominal friction, and gave sulphate of quinine, 8 grains. 
Continued to give quinine and ergot, but the uterus stub- 
bornly refused to respond. An examination now revealed 
the head at the inferior "strait. 1 now gently pushed the 
anterior lip back over the head, and at 11:30 a. m., five hours 
after arriving at the house, applied Simpson's forceps and 
delivered her of a fine, healthy boy. The placenta was ex- 
pressed easily by Crede's method, and firm contraction oc- 
curred immediately. No post partum hemorrhage followed. 
My patient did not have a pain at any t;me, except when 
the head came down against the perineum. She then 
assisted some by bringing the abdominal muscles into ac- 



Our Clinical Society. 23 

tion. I could have terminated labor immediately upon 
arriving at her residence. It would have been interesting 
to know whether labor would have been completed with- 
out pain if artificial means had not been employed. 



Art. X.— Case of Tubercular Meningitis. Reported by O. J. Roskoten, M. D., 
Peoria, Illinois. 

April 19th. — I was called to see F. S., aged 10 years. 
Interrogation of parents revealed the following history: 

About eight months ago the boy was thrown violently 
to the ground in a runaway accident, in which he sustained 
some injury of the back, which was treated at the time 
with apparent success by a surgeon of this city. Several 
weeks later pain in back and various neuralgias returned, 
indicating carries of the dorsal vertebrae, which eventuated 
in very marked posterior curvature, for which an apparatus 
was devised and worn by the patient for several months. 
Although this relieved the pains considerable, it did not 
check the ulcerative process in the vertebrae. Appetite re- 
turned, however, and the boy grew more cheerful, but a 
mild and dry cough, attended with occasional fever, espec- 
ially in the evening, supervened, which gradually increased 
in severity, with progressive emaciation, until for two 
weeks before I was called the boy was obliged from weak- 
ness to take to bed several times a day. About this time 
he began to grow more fretful, caikpricious in appetite, 
changing suddenly from a cheerful mood to one of depres- 
sion, often shunning light, frequently complaining of gen- 
eral or localized headache, and vomiting occasionally. 
These prodromic symptoms were not recognized as- serious 
by the parents, until suddenly without warning, on the. 
19th of April, the lad passed into profound coma, having 
the moment before called for his breakfast. On examina- 
tion, I found that there was no response to the loudest 
speaking into his ear; the eyes were rolled up under the 
lids, the right pupil dilated to its utmost, almost insensible 
to light, but oscillating slightly, while the left was much 
smaller, reacting feebly to light. All limbs in a state of 



24 The Peoria Medical Monthly. 

flexion, but not rigid, returning to that position when ex- 
tended. Pulse very irregular, about 120, feeble. Respira- 
tion 36, also irregular. Patient lies motionless. Drinks 
swallowed automatically, with difficulty. 

Expecting speedy death, I did not examine lungs. In 
the evening condition the same, except that patient ap- 
pears to hear, if not understand, when loudly spoken to. 
Pupils now evenly and extremely dilated. Urine and 
faeces passed into bed. Respiration 36, sighing. Pulse 
160, irregular. Sudden yells or cries. Little or no fever. 
Later in the evening patient slightly conscious, taking 
passing notice of things around him; condition of pupils, 
pulse and respiration same as before. Drinks much better. 
Speaks a few incoherent words. Local perspirations on 
head and face. 

1 now examined the lungs and found them tubercu- 
lous, the right lung being riddled with cavities and patches 
ot consolidation, the left lung being affected to an inch be- 
low the clavicle, the condition of tuberculosis being evi- 
dently the result of the carious process in the vertebrae, as 
there is no history of the disease in the family. I had, 
therefore a case of general tuberculosis, the meningeal 
affection predominating. 

The next two days the boy was generally quiet, but 
alarming the attendants several times by outbreaks of 
maniacal frenzy, tearing his clothes and the bedding, wildly 
biting his lingers, and madly clutching anything he could 
lay his hands on, one such attack lasting nearly two hours, 
after which he relapsed into his usual state of apathj^ An 
ice cap was used with little benefit, and nervous sedatives 
were not more effective in quieting the excitement. Opi- 
.ates, however, given in large doses at night, procured con- 
siderable sleep. The next day the boy could at times be 
around, and appeared perfectly rational for a few moments 
at a time, unable, though, to speak. There was complete 
aphasia or aphokia. The muscles at back of neck con- 
tracted. Evanescent patches of erythema were noticed on 
the face for several days. The patient appeared to have 
some pain in region of liver and in the epigastrium, prob- 
ably of a neuralgic character and of cerebral origin. 



Our Clinical Society. 25 

These symptoms continued for several days, when an- 
other paroxysm of fury occurred. The pupils now evenly 
dilated and absolutely insensible to light, though patient 
appears to notice a bright lamp ; constant rolling of head 
from side to side; child incessantly moaning, ever and anon 
uttering a subdued shriek. Retraction of abdomen not 
marked; no paralysis, but unconscious escape of urine and 
faeces. 

At my next visit sight and audition were entirely gone; 
pulse 180; respiration about 40. Another attack of violent 
rage occurred, this day followed by restlessness, ptosis of 
right eyelid, and nearly complete insensibility of eye to the 
touch. The limbs then became relaxed and extended. In 
this condition the boy is said to have regained conscious- 
ness and speech, calling for his mother, and remaining 
rational for a few minutes, after which violent general 
clonic convulsions of several hours' duration supervened, 
during which patient expired, on the 7th day after alarm- 
ing symptoms first developed. The case being hopeless^ 
little medicine was given. 



Aet. XI. — Retroversion of a Gravid Uterus (Supposed) Rectified by an Ac- 
cident. By Thos. M. McIlvaine, M. D., Peoria, Illinois. 

The following case may be of some interest as a "bit 
of experience," and while the writer may be open to 
censure for non-interference, he believes in recording our 
errors as well as successes. 

Mrs. B. L., aged 23, 11. para, requested my services. On 
visiting her I found the following condition: Was in the 
fifth month of pregnancy; had been sick for ten days; 
frontal headache, intense backache, pain in right lumbar 
and iliac regions; had had chills every morning for four or 
five days. Bowels not opened for four days; tongue foul 
and dry. Almost constant nausea. Constant desire to 
void urine, which was attended with severe pain. Tem- 
perature 102. Pulse 120. 

As all symptom had come on after some unusual ex- 
ertion ten days before, I suspected some malposition of the 
uterus, and requested an examination, which, however, was 



26 The Peoeia Medical Monthly. 

at her request postponed until my next visit. Prescribed 
a cathartic — a fever mixture, and 20 grains of quinine in 
six doses. 

Next day I found her no better, except that the chills 
did not return. Other symptoms unchanged, except vesi- 
cal tenesmus, which was increased. Attempted the vaginal 
examination, but was compelled to desist by the extreme 
vaginitis and rectitis which I encountered. Abdominal in- 
spection and palpation did not reveal the fundus of the 
uterus where it might have been expected, and this added 
to my opinion that it was a retroverted uterus that we had 
to deal with. Anodyues were indicated and I gave mor- 
phia, also vaginal and rectal suppositories of belladonna, 
bismuth, and cocoa butter. 

Believing that the replacement of the uterus was 
urgently demanded, I visited her again in the afternoon, 
accompanied by Dr. J. L. Hamilton, with the purpose of 
administering an aaesthetic and accomplishing the desired 
replacement. 

Man proposes many things that women quickly dispose 
of, and here the lady firmly refused the anaeshetic. An 
examination without it was again attempted, but failed. 
No amount of persuasion could gain her consent to the 
anaesthetic, and it had to be given up for the time. We 
placed her on her knees and chest, but without any result. 
The pain in the back she described as intense and constant, 
"As though something was stretched to its utmost and 
might give way at any moment." Bowels had not moved; 
repeated cathartic and ordered injections; continued ano- 
dynes. 

On my next visit found " pain not relieved in the least; 
could not sleep a wink;" bowels not opened; unable to 
turn on either side; urine not passed for twelve hours, con- 
stant desire without avail; vaginitis and rectitis no better; 
on passing catheter met an obstruction at the neck of the 
bladder, which I supposed to be due to the pressure of the 
cervix upwards (presuming that the fundus was turned 
back); stopped physic, but continued injections; substitued 



Our Clinical Society. 27 

papaine for morphia; also gave chloral and potassium 
bromide in liberal doses. 

The history of the next ten days would be but a repeti- 
tion of the foregoing. 

The pain increased until hypodermatic injections of 
morphia, i to | grains every four hours, were demanded. 
Retention of urine continued. After eight days some faecal 
matter was passed, but evidently from lower bowel only; 
abdomen became tense and tympanitic, with great tender- 
ness on pressure, especially in right iliac region. Vomiting, 
which had been persistent since conception, gave great 
trouble in nourishing the patient. Emaciation was rapid, 
and face became haggard; anaesthesia still refused. Every 
symptom grew worse; pulse more rapid and feeble; temper- 
ature constantly over 100 deg. Fahrenheit, and everything 
seemed to predict a fatal termination. 

After ten days the overtaxed nervous system gave en- 
tirely away, and for the five days and nights following 
there was a constant succession of hystero-epileptic spasms, 
with low delirium, especially during the nignt. I made 
repeated attempts to obtain a more satisfactory vaginal 
and rectal examination, either with anaesthetics or during 
an unconscious moment following the spasms, but without 
succeeding, and then 1 tried to give up the case, but with 
like result. 

On the eighteenth day of my attendance the spasms had 
increased in severity, so that she required constant watch- 
ing to prevent her from getting out of bed. After my after- 
noon visit on that day, the thoroughly tired-out attendants 
relaxed their vigilance for a few moments, and she arose 
from the bed, took one or two steps, and fell headlong upon 
the floor. The shock was great, and consciousness did not 
return for three hours. On my arrival she was just coming 
to, and in answer to my question, said: '*! am better; the 
pain in my back is gone." A short time after she voided 
the urine without the catheter, for the first time for fifteen 
days. I introduced the catheter, however, and found that 
the obstruction at the neck of the bladder was gone. The 



28 The Peoeia Medical Monthly. 

fundus of the uterus was felt above the pubes, and the ab- 
domen regained the shape it ought to have. 

From that moment her condition improved rapidly, 
almost marvellously. The pain was gone, retention of urine 
gone, temperature lowered, pulse stronger, nausea relieved, 
tongue cleaned up, and she was able to rest comfortably on 
either side. The vaginitis was quite troublesome, but 
gradually left her, and the spasms returned but a few times 
after her fall. 

From this necessarily condensed report, I think but few 
will be inclined to differ with me as to diagnosis; as to 
treatment, however urgently indicated, the let alone plan 
was not of my own choosing, and I believe her recovery and 
life to be entirely due to her very fortunate accident, in 
which, falling as she did at full length upon her face, 
the retroverted uterus was thrown forward to its natural 
position. 

Many other points of interest in this case might be 
given, but the report is already too long. The vaginitis 
was due to a recto-vaginal fistula, of which I knew nothing 
until after several days attendance. After her fall, the lady 
got around again and went to her home, where she was 
delivered at the proper time of a healthy child. 



Art. XII— a Remedy for External Hemorrhoids. By L. L. Leeds, M. D. 
Lincoln, Illinois. 

Those broad-based tumors at the verge of the anus can 
always be helped and frequently cured by the frequent ap- 
plication of collodion. It contracts the distended skin and 
tissues, thereby relieving the congestion. The bowels 
should of course be kept regular, constipation of the 
bowels being the most frequent cause of the difficulty. 



Intense Itching. 

Startin recommends sponging the parts once or twice 
a day with pure rectified spirits, containing five minims oi 
carbolic acid to the ounce. — Columbus Medical Joournal. 



Society Transactions. 29 



American Medical Association. 

As the full proceedings will shortly be published in the 
Association Journal, and as much that transpires is of little 
general interest a.ny way, we will make but a brief abstract, 
only touching on those points that are of real general inter- 
est, omitting details of all kinds. 

The Association met on Tuesday, May 6th, 1884, with 
the President, Austin Flint, M. D., in the chair. 

He took for the text of his annual address the pre- 
amble to the organization of the Association, and it was 
chiefly a review of the past and present status of the pro- 
fession. He suggested the appointment of a standing 
committee, to communicate with the state societies and 
medical colleges, wdth the view of securing uniform action 
concerning the requirements for matriculation and gradu- 
ation. 

He thought the idea of having medical examining^ 
boards, independent of the teaching body, to be imprac- 
ticable. 

He submitted the recommendation that the Associa- 
tion adopt resolutions embodying the grounds, more satis- 
factory than they are given in the code as it now stands, 
for refusing fellowship with irregular practitioners. With 
regard to emergencies, there was no antagonism between 
acts of humanity and the code of ethics. 

The address was referred to a committee of seven, to 
consider its suggestions, 

A committee was appointed to secure the meeting of 
the International Medical Congress in this country, in 1887. 

Dr. Atwood, of St. Louis, offered a memorial from the 
St. Louis Medical Society, on the subject of medical college 
advertising, which criticized severely the questionable 
methods of medical colleges and schools in this direction. 
Referred to the Judicial Council. 

Then came one of the most exciting episodes of the 
meeting. 

Dr. D. Benjamin, of New Jersey, offered the follow^ing 



30 The Peoria Medical Monthly. 

resolution, and supported it with a vigorous speech against 
medical colleges. 

Besolred, That this Association earnestly urges upon 
all American medical colleges the necessity of elevating 
the standard of education, at least so far as to require pre- 
liminary examination and a three years' course, a registry 
of attendence, and practical demonstration of diagnostic 
skill. 

The resolution gave rise to discussion, participated in 
by Dr. Brodie, of Michigan, who was willing to vote for the 
resolution if the end desired could be accomplised in that 
way, and Dr. Keller, of Arkansas, who thought that when 
preceptors furnished the medical schools good material, the 
schools, in turn, would give the profession educated medi- 
cal men. 

A motion was made to lay the resolution upon the 
table, and amid considerable confusion was put and de- 
clared carried. 

Dr. M. H. Henry, of New York, said that every time 
this question had been brought before the Association it 
had been squelched in the most undignified manner. 

Dr. Quimby raised the point of order that the negative 
vote had not been taken when the motion to table was 
declared carried. 

The vote was taken again : ayes, 76 ; nays, 150. 

Dr. Henry then supported the resolution with a vigor- 
ous and caustic speech, and did not shrink though met by 
hissers, to whom he administered scalding reproof. The 
possession of a medical diploma obtained in this country 
he regarded as no evidence of qualification to either prac 
tice medicine or fill important and responsible medical 
positions. 

Dr. Gibson supported the statement. 

After some further random shots and calls of question, 
the resolution was adopted. 

The President explained that the decision that the 
motion to lay upon the table was carried, the negative vote 
not having been taken, was an oversight, and further added 
that he was in sympathy with the spirit of the resolution. 

The Board of Trustees of the Association Journal re- 



Society Transactions, 31 

ported through Dr. J. M. Toner. It appeared that the total 
income for. the first year was $18,547.50; expenses $500 
less. Dr. Davis resigned editorship, but had consented to 
act another year. 

Dr. J. H. Packard presented a minority report, signed 
by himself, saying that the Journal had not approached 
anywhere near what the standard and established organ of 
the Association should be. He thought it was not intended 
merily to be a journal of the proceedings of the Association, 
but a strong, positive periodical, the organ of the Associa- 
tion, and the exponent of the latest ideas in medical 
knowledge. He recommended that the resignation of the 
editor be accepted, that a trained paid corps of editors be 
employed, and the office of publication be removed to New 
York, Philadelphia or Washington. 

The minority report was laid upon the table by a vote 
of 191 to 74, and the majority report adopted. 

The Committee on Nominations reported : that the 
next meeting be held in New Orleans, on the last Tuesday 
in April, 1885. 

President, H. F. Campbell, of Georgia ; Vice Presidents, 
J. S. Lynch, of Maryland, S. D. Mercer, of Nebraska, J. W. 
Parsons, of New Hampshire, H. C. Ghent, of Texas. 

Dr. J. H. Packard presented the revised amendment 
offered at St. Paul, viz., "That membership shall be acquired 
by any one received as delegate, and that he shall remain 
a permanent member as long as he continues, in good 
standing in the Society from which he is sent, and, keeps 
up his annual dues." Adopted after a long discussion. 

Dr. Von Klein, of Ohio, an amendment to the Constitu- 
tion, providing that graduates from medical colleges which 
do not require literary education as a prerequisite to gradu- 
ation, shall not be eligible to delegateship to the Associa- 
tion, but it shall not apply to the army and navy. 

Dr. Keller asked that his resolution concerning crema- 
tion be referred to the section on State Medicine. Crema- 
tion in the near future, in large cities, will be a sanitary 
necessity. 

Dr. Pratt, of Michigan, offered an amendment to the 



32 The Peoria Medical Monthly. 

Constitution, to the effect that the Chairmen and Secre- 
taries of sections hereafter be elected by each section. 

Dr. Cochrane, of Alabama, offered an amendment that 
the Nominating Committee shall not nominate from their 
own number for officers. 

Dr. Pratt, of Michigan, offered the resolution earnestly 
urging Congress to legislate to prevent immigration of 
defective classes to this country. 

To conclude, we take from the same source, the Medical 
Record, 

some general impressions of the meeting . 
by a correspondant. 

Sir: The meeting of the American Medical Associations 
has been a successful one, and enjoyable to those attending. 
There were no serious dissensions in the meetings, although . 
small clouds occasionally arose. The President's address 
was well received ; but excited less comment than might 
have been expected It seems to be a general impression,, 
especially among Western delegates, that the ethical ques- 
tion is, after all, only a technical and minor one not worth 
having a quarrel over. There is not any real difference of 
opinion among the mass of intelligent physicians upon the 
subject of consultations. An old member of twenty years' 
standing, who had signed the "Pledge," told me that he 
recently consulted with a homoeopath, and with benefit 
to the patient. The great thing, he said, which keeps 
homcEopathy alive out West is the antagonism and oppo- 
sition it meets from us. We ought not to antagonize, but 
to absorb it. 

The President in his address deprecated the criticisms 
upon medical colleges and medical men which have been 
so uniformly made of late. The subject of medical educa- 
tion came up, however, and it was shown that the mem- 
bers were not in sympathy with the President upon the 
subject. A decision was made that the subject be laid 
upon the table ; but when it was shown that this decision 
had been made, without having the President's calling for 
the nays, on a full vote, the subject was kept before the 
Association, but not very much was done except to pass a 
resolution. 



Society Transactions. 33 

It requires some courage for Dr. Packard to organize 
an opposition to the Journal management. He secured a 
hearing and a vote, however, despite some parliamentary- 
opposition. I hear but one opinion as to the character and 
management of the Journal, but it is unpleasant to antago- 
nize a gentleman so respected as its editor, and besides, it 
is said that if not a model Journal it has done some good, 
and is better than the "Transactions." 

I have seen a large number of Western men here ; New 
York was also well respresented, even better than Phila- 
delphia, while Boston men were very few. 

The work in the Sections was very uneven. There 
was a considerable change from the printed programmes, 
many of the best papers announced not being read, owing 
to the absence of the authors. 

The Section on Practice was unusually good, the sec- 
tions on Surgery and Obstetrics were above the average. 
The other Section meetings were, on the whole, poor. 

There were about 1,250 members registered. 

* * * * 



Peoria City Medical Association. 

[Regular Meeting, March 25th, 18S4.] 

H. STEELE, M. D., PRESIDENT, IN THE CHAIR. 

Report for the evening was from the Committee on Ob- 
stetrics and Diseases of Women and Children, and consist- 
ed in a paper by Dr. J. L. Hamilton, on 

DIAGNOSIS OF OVARIAN TUMORS, 

which will be found in full in the last issue of this journal, 
Vol. IV, No. 12. 

Abstract of Discussion: 
Dr. N. Holton compared the operation of ovariotomy, 
as performed to-day, with the first ovariotomy by Dr. Mc- 
Dowell, before the diagnosis was clear and before the dis 
covery of ansesthetica. Thinks the diagnosis becoming 
more easy and the operation more successful. Thinks 
cleanliness and absolute care in details the secret of suc- 
cess. Notices that the idea in regard to the temperature of 



34 The Peoria Medical Monthly. 

the room in which the operation is performed has changed' 
of late 3'ears. it being formerly held that the temperature 
should be from 75 to SO degrees, while now it is permitted 
to fall as low as 60 degrees without affecting any difference 
in the result. 

Dr. J. P. Johnson referred to the old story that Mc- 
Dowell got his idea of performing (the operation from the 
fact that a pig spayer of the neighborhood had already suc- 
cessfully operated on a woman. Thought it would be in- 
teresting if we could know what was the first cell disturb- 
ance or displacement that gives rise- to the formation of 
the sac that becomes so enormously enlarged. 

It is possible that if it could be diagnosed in time, it 
could be rendered a much simpler operation ; and indeed, 
it is possible that if it was recognized in time some of our 
remedies might stop its growth. 

Dr. R. Boal — Despite all that can be done, the diagno- 
sis of some cases of ovarian tumors will not be clear, and 
we may be mistaken even after examination of the fluid,, 
which has been supposed to be a pretty sure test. 

Some years ago was called in consultation to a case of 
supposed ovarian tumor. After examination I asked the 
attending physician if he was sure of his diagnosis ; he re- 
peated the examination and still said it was an ovarian 
tumor. 1 told him it was an enlarged spleen, and so it 
proved on a p(M mortem examination. 

There is only one treatment — extirpation. Tapping 
and injection of iodine may sometimes cure, but generally 
they only postpone the inevitable. Believe that early op- 
erations are the best. 

Dr. J. L. Brown — Thinks the only treatment is an 
early removal of the tumor ; tapping is apt to cause ad- 
hesions. Thinks that more than one tapping (for diagno- 
sis) reprehensible. Thinks that McDowell got his first idea 
of the operation in Edinburgh from his preceptor. 

Dk. T. M. McIlvaine— Tapping, whether it shall be fre- 
(juent or not, is yet to some extent mh judice. Some de- 
mand an early operation, which, of course, precludes fre- 
quent tappings. Others have claimed, and with some 



Society Transactions. 35 

reason, that the existence of the tumor for some time, by- 
pressure inures the peritoneum to such an extent as ta 
measureably preclude peritonitis following the operation. 
The peritoneum becomes accustomed to the presence of 
the tumor, loses its sensitiveness and better withstands the 
handling of the operation. 

The objection of Dr. Brown to frequent tappings, that 
it causes adhesions, does not seem well founded. The ad- 
hesions following tapping (if anjO will be on the anterior 
wall of the tumor, while the adhesions which give the most 
trouble, and which are most to be feared, are those on the 
posterior wall of the tumor and deep in the pelvis. These 
cannot be caused by careful use of the aspirator. One case 
alluded to by Dr. Hamilton as among the successful cases 
operated on in this city, is deserving of more notice, al- 
though the operation was performed by a homeopath from 
Chicago. The patient was about 57 years of age and 
claimed to have been tapped over 45 times. I assisted in 
the last few tappings. She then had to be tapped every week 
and the amount of the fluid obtained each time was a 
wooden pail full. When last tapped, she informed us that 
her friends had sent to Chicago for an operator and that he 
would be there the following day. Her condition was very 
poor. She had been confined to her bed by prostration for 
a long time, and I feared that she could not stand even the 
last tapping. Her radial pulse was scarcely perceptible, 
and her voice was so feeble that it could not be heard 
across the room. The case was a most unpromising one, 
and I did not believe she could recover. The operation 
(as I have been informed) was long and tedious, complicat- 
ed by some very strong adhesions posteriorly, though there 
were very few on the anterior wall, where she had been so 
repeatedly tapped. She recovered after a six weeks' illness 
and is still living. The operation was made about four 
years ago. 

Ttie operation has been made at all ages. Dr. Cheno- 
with, of Decatur, has operated, 1 think, on a patient of un- 
der five years of age. The weight of the tumor varies from 
one pound to over 100 pounds. There is now a case in St. 



36 The Peoria Medical Monthly. 

Louis in which the tumor is estimated to weigh nearly 200 
pounds. They intend to remove the woman from the 
tumor soon. Have noticed quite a percentage of these 
tumors to be of the dermoid variety. Would like to know 
the exact proportion. It might be that all of these simple 
ovarian cysts are of that character, in their origin at least. 

Dr. 0. B. Will— The diagnosis of these tumors in the 
pelvis and abdomen is, and always will be difficult. The 
most reliable guide we have is a thorough knowledge of 
anatomy and relations of pelvic and abdominal regions, 
and then arrive at the diagnosis by exclusion. Impaction 
of the fieces in the colon may be taken for this kind of 
tumor. Has had two cases of this character, but relieved 
by the use of belladonna inunctions and injections by the 
rectum. The treatment cause great pain in both cases un- 
til the colon was emptied. 

The microscopical and chemical examination of the 
contents of these tumors is not always satisfactory. Had 
lately sent some to Dr. Garrigues, of New York, who replied 
that he could not give him much satisfaction, also writing 
that the test was not always certain. 

Dr. Boal — A large pelvic abcess may be mistaken for 
ovarian tumor ; saw a case of this kind some years ago, 
which when opened, discharged a gallon ot very offensive 
pus. 

Dr. Steele — Thinks one cause of the greater success 
in operations in later years is due to the abandonment of 
the clamp. The less tension on the pedicle, the better. 

Dr. Hamilton — Thinks tapping with the trochar dan- 
gerous ; the aspirator should always be used, both for safe- 
ty and because a cyst may be better evacuated by the small 
needle than the large trochar. Most operators tie and re- 
place the pedicle, though a few still adhere to the clamp. 



(I(«irulkr MeetlDK, Tu«§c]ay, April Slli, 1^4.) 

PRESIDENT II. STEELE IN THE CHAIR. 

Dr. Noble Holton read a paper on 

PNEUMONIA, 

(printed in full in this issue,) which elicited a general and 



Society Transactions. 37 

very interesting discussion, of which, however, owing to 

limited space allowed, only a brief abstract can be given. 

Abstract of Discussion: 

Dr. H. T. Coffey— Pneumonia is one of the diseases in 
which the lancet can be used ; when the patient is young 
and vigorous, bleeding will do good, if employed early. 
Has more faith in calomel and opium than in aconite or 
veratrum. Prefers to treat it without quinine, unless as a 
stimulant in well-marked nervous cases, with malaria. 
Blistering is too much neglected. Has no confidence in the 
ergot treatment, which will prove a failure. 

Dr. J. L. Brown — Must remember that many diseases 
are self-limited. Some cases will recover without treat- 
ment ; others die under the most approved. Well to keep 
this in mind. Thinks the proportion of recoveries larger 
since bleeding has gone out of fashion. Local cupping will 
often be beneficial in the first stages. Treatment should 
be directed to restoring the normal condition of the circu- 
lation. 

Dr. L. H. Spalding — Thinks the action of aconite and 
ergot would indicate their use in this disease. Does not 
think pneumonia can be satisfactorily treated in this clim- 
ate without quinine. 

Dr. R. Boal — Etiology dependant largely upon meteor- 
ological conditions ; have had it some years as a sort of ep- 
idemic. In the stage of engorgement believes bleeding to 
be proper. In general must treat each case on its merits. 
In first stage believes blistering does harm to the patient. 

Dr. J. Murphy — The theory that it is exclusively a 
constitutional disease will not hold good. Cannot recall a 
single case where it could not be traced to a local circum- 
stance. Routine treatment in pneumonia does perhaps 
more harm than in any other disease. In fact, believes 
wholly in the expectant treatment, or in not treating it at 
all with medicine. Has seen three persons within a week, 
in consultation, who have since died, and he cannot believe 
that if less quinine had been given, their chances would 
have been better. Thinks the expectorant mischief the 
greatest of all. 



38 The Peoria Medical Monthly. 

Dr. J. P. Johnson — Thinks it generally constitutional,, 
and believes in active treatment. Ergot will secure the 
desired capillar}^ contraction. Tartar emetic may control 
the fever and assist in breaking down the exudate ; bleed- 
ing will have the same effect. In later stages give mercury 
to promote absorption. Can get the full efficacy of blister- 
ing by giving tincture of cantharides. 

Dr. Coffey — Calomel is valuable in cases of impaired 
constitution, with deranged liver, etc. Give, say, 10 grains 
calomel every two or three hours until the liver acts. 



(Regular Meeting, Tuesday, April 22a, 1884.) 

DR. H. STEELE, PRESIDENT, IN THE CHAIR. 

Following his paper on 

FRACTURES OF THE SKULL, 

(printed in this number of the Monthly,) Dr. Stewart add- 
ed the following remarks : 

My attention has been especially called to this subject 
recently, having seen a good many cases of depressed skulls 
that have been injured ten or twenty years. Every one of 
them have trouble, some of them of the most serious char- 
acter. Some have gone partially blind ; others have dizzi- 
ness in the head, intense pains in the head, sometimes fall 
down on the street, confusion of the mind, loss of memory; 
some of them epileptics and some imbeciles. 

I knew a man in this city whose skull was depressed 
and never trephined. He was almost idiotic, and finally 
died. 

I meet another man on the streets every few days who 
has a depressed place in his forehead, done before the war. 
But he is a wreck ; cannot see to read and cannot trust 
himself alone on the street, as he is liable to grow dizzy 
and fVill. I know it is an easier way of getting along with 
a patient who has had a lick on the. head and had the bone 
depressed. If he has not had signs of compression of the 
brain, it is easier to put on a compress and treat him gen- 
erally than to elevate the bone, but it is doing an outrage- 
ous injustice to the man. Suppose one should die from 
trephining; there are many who had better die at first,. 



Society Transactions. 39 

than suffer from not trephining. If the bone can be ele- 
vated, there is little danger. In the case of children, es- 
pecially, with comminuted fractures, there is little danger, 
as then the brain will usually force the skull up and to its 
place, and as it grows it adjusts itself to the circumstances 
better than that of an older person ; but even then it 
should be relieved in every instance, especially if a com- 
pound fracture. The great question is to know what cases 
will do to let alone. We cannot tell what the extent of 
the depression of the inner table is. There may be much 
more than of the outer table, but where there is only a lit- 
tle depression, it is probably good practice to wait until 
symptoms of compression show themselves. If they do, 
would then trephine, even if there was no depression of the 
outer table at all. 

I saw two men in Orange Prairie who, if I were called 
to treat now, I would trephine. Both of them are gone 
and so I do not know what condition they are in. One man 
had a compound fracture with outside depression, but 
showed no evidence of compression of the brain, and a 
week afterwards was in the harvest field. Of course he 
should not have been there, but he was, and I afterwards 
lost track of him. All such cases should be operated on 
promptly. 

Abstract of Discussion. 

Dr. Miller — Agree with Dr. Stewart in regard to early 
operative procedure. When the injury is received is the 
time to correct the deformity, should any exist. Think 
waiting for the brain to accommodate itself is unwise. I 
knew of a case where fractured skull proved to be a cure 
for neuralgia. A gentleman who had suffered from neural- 
gia could find no relief, even opium only giving partially 
temporary relief, received a kick from a mule, fracturing 
the skull above the right eye brow. The bone was elevat- 
ed and he recovered without any untoward symptoms, and 
free from the neuralgia. 

Dr. McIlvaine — Agree with Dr. Stewart's* remarks 
about the necessity of early elevation ; sometimes, howev- 
er, there are symptoms of depression following injury 



40 The Peoria Medical Monthly. 

where trephining would do no good. A blow on the skull 
may injure the brain on the opposite side of the head ; 
cases of contra coup. In these cases trephining at the point 
of injury would give no benefit, as the inner table would be 
intact, and the injury would be to the other side of the 
brain. 

An interesting case was related to me by a doctor from 
Iowa, coming under this topic. A man received a bullet 
wound in the frontal bone. The bullet plowed its way 
through the skin and was recovered. They picked out a 
few fragments and elevation was accomplished. The case 
got along well, but some two years afterwards the patient 
came back complaining of an intense pain about the cen- 
ter of the left parietal bone ; pain was always intense and 
at the same point. Ail efforts to relieve the pain were fu- 
tile. The patient insisted upon trephining, which, being 
done, a portion of the bullet was found and the pain re- 
lieved. About a year and a half after that the patient re- 
turned with exactly the same pain at a point farther down 
and back of the point of trephining, and at the time the 
doctor was at my office, he was in doubt whether it was 
best to trephine or not. 

Dr. Holton — Think the demand for trephining in 
many cases is absolute. In some cases it cannot be de- 
layed. The question arises in determining which cases de- 
mands it. 

In 1848 a man in Milwaukee had his skull fractured in 
two or three places by an assassin. He was found some 
hours afterwards, when perhaps an ounce and a half of 
brains lay on the ground. He was taken to the hotel and 
as he did not die, was taken to Chicago, where Prof. Daniel 
Brainard trephined him in three places, taking out eight to 
ten spicula. There was paralysis of one side of the body, 
with frequent epileptic convulsions, but in 30 days the man 
walked into the college and seeing an operation performed 
said he would rather see it done on some one else than on 
himself. 

Dr. Robert Boal -Have always believed until the last 
year in the old saying, never triphine until symptoms of 



Society Transactions. 41 

compression came on ; but I have seen lately several cases 
where the sequelae in cases where operations had been de- 
layed were so grave, where vision or hearing was destroyed 
or where epilepsy or partial paralysis had resulted, perha]5s 
from neglect of the proper treatment, that I believe with 
Dr. Stewart, that in all cases where depression is found, 
trephining should be resorted to, unless in the case of 
young children. 

Dr. 0. J. RoKOTEN wished to know if we were justified 
in trephining in cases where there were symptoms of com- 
pression without depression. 

Dr. Hamilton — If we always knew where to trephine 
in the class of cases mentioned by Dr. Roskoten, we would 
be justified in doing so. Some months ago a man fell from 
a house ; had no fracture of the skull, but symptoms of 
compression. Lived some four or five days. Post mortem 
revealed clot in brain. Had we known where to trephine, 
might have saved his life. Trouble is to find the place. 

Dr. Coffey — It is the opinion of surgeons now, more 
than of old, that where there are symptoms of compression 
it is best to try and relieve them at the time, whether there 
is a fracture or not. I remember three cases. One caused 
by blow on parietal bone, causing contused wound, coma, 
paralysis and other symptoms of compression ; no fracture 
evident ; trephining, we found nothing to account for the 
compression ; no post mortem. Second case : Man struck 
with the fist ; coma ; profound insensibility ; several hours 
after blow was received was taken to hospital. Diagnosis: 
compression. Trephining did no good. Post mortem 
showed fracture of internal table at base of brain. In the 
third case equally futile. It is a dangerous thing to bore 
into a man's skull for mere symptons of compression of the 
brain. ' 

Dr. Steele — If the time may come when physicians 
will be able to tell from symptoms the exact location of the 
effusion — which time may possibly come — think trephining 
at that point to relieve pressure would do good. It is gen- 
erally caused by clot. Dr. Daniel Brainard operated on a 
young man 27 years of age, who was injured when 10 years 



42 The Peokia Medical Monthly. 

of aoje. He was in epileptic convulsions even under the in- 
fluence of chloroform, and trephining did not relieve him. 
Dr. B. spoke of the necessity of operating at the time of 
fracture. 

Dr. Stewart— I do not pretend to say that trephining 
will do in all cases ; it will do no good in case of fracture 
of base of brain. In many cases the injury which fractures 
the skull is so great as to produce great injury to other 
parts of the brain. It will do little good to trephine for 
symptoms of compression. If a man's skull was depressed 
trephining a year afterwards will do no good, unless there 
are spicula pressing down. An occasional case may occur 
of a man receiving injury at a ceitain point, and trouble 
afterwards arising at that point that would justify trephin- 
ing, but it is always uncertain. The great thing is to tre- 
phine when it should be done. 



Illinois State Medical Society. 

The following is the report of the Committee of arrange- 
ments for the 34th annual meeting, to be held in Chicago, 
May 20, 21, 22 : 

The following Committees are expected to report : 

STANDING COMMITTEES. 

Practical Medicine — J. C. Frye, Peoria; J. W. Hensley, 
Yates City ; N. S. Head, Chanderville. 

Surgery — Roswell Pa,rk, Chicago; David S. Booth, 
Sparta ; J. D. Whiting, Petersburg. 

Obstetrics — S. K. Crawford, Monmouth ; E. A. Ingersoll, 
Canton ; C. DuHadway, Jerseyville. 

Gynecology — W. S. Caldwell, Freeport ; A. C. Corr, Car- 
linville ; A. F. Rooney, Quincy. 

Ophthalmology and Otology — J. P. Johnson, Peoria ; 
Robert Tilley, Chicago ; P. H. Garretson, Macomb. 

Drugs and Medicines — B. F. Crummer, Warren ; J. H. 
Robinson, Chicago ; T. M. Cullimore, Concord. 

Necrology — E. Ingals, Chicago ; Wm. Hill, Blooming- 
ton ; W. West, Belleville. 

SPECIAL COMMITTEES. 

Oral Surgery — J. V. Black, Jacksonville. 
Tetanus — C. Truesdale, Rock Island. 
Vaccination — M. F. Bassett, Quincy. 



Book Notices. 43 

Diseases of Chidren — J. P. Matthews, Carlinville. 

Physiology — A. Wetmore, Waterloo. 

Committees on Legislation for the Insane — Walter Hay, 
Chicago, Chairman ; E. P. Cook, Mendota ; Wm. Hill, 
Bloomington. 

The Diagnostic Peculiarities of Malignant Growths — 
Christian Fenger, Chicago. 

Analysis of a certain class of Remedies, concerning 
which Physicians are not positive as* to their therapeutic 
value — W. L. Ransom, Roscoe. 

Simple Renal Catarrh — I. N. Danforth, Chicago. 

VOLUNTARY PAPERS TO BE PRESENTED. 

On Surgical Treatment of Gangrene of the Lung — By 
C. Feiiger, of Chicago. 

On Excision of the Hip and Knee-joints, with special 
reference to the final results and exhibition of patients — 
By C. Fenger, of Chicago. 

The Meetings of the Society will be held in the Hall of 
the Methodist Church Block, on the south-east corner of 
Olark and Washington Streets, beginning on Tuesday, at 

10 A. M. 

A Banquet will be tendered the Society by the Medical 
Profession of Chicago, at the Grand Pacific Hotel, on 
Wednesday evening, at 8 p. m. 

Railroads will return delegates or members of the 
Society, who have paid full fare in coming to the meeting, 
for one-third fare, on presentation, at their Chicago offices, 
of a certificate properly signed, which be obtained at the 
time of registration. 

D. W. Graham, C. G. Smith, H. A. Johnson, E. Ingalls, 
R. C. Hamill, J. F. Todd, Ex-officio, Committee of Arrange- 
ments. 



§00^ fotir^^. 

Elementary Principals of Electro-Therapeutics, of the use of students and phy- 
sicians, with 135 illustrations. Prepared by C. M. Hayn'^s, M. D. Cloth. Pp., 
426, Price, $2.00. Chicago. Mcintosh Galvanic & Faradic Battery Co. 1884. 

Dr. Bryce, editor of the Southern Clinic, says about this 
book just what we want to say, and we therefore copy and 
endorse his review heartily. 

Of all the good books that we have read on electro-thera- 
peutics, this is decidedly the most satisfactory. We do 
not mean by this to say, that this work discusses the sub- 
ject of electro-therapeutics at greater length than other 



44 Thi Peoria Medical Monthly. 

works of recognized authority. But, the great value of this 
work consists in the fact, that the student is taught in the 
clearest possible manner the principles of electricity and is 
thus gradually brought step by step to a full comprehen- 
sion of the entire subject. The author starts at the very 
first principles and with the most primitive forms of appa- 
ratus. The student is first made acquainted with the 
various characters in which electricity exhibits itself under 
various circumstances. The why and wherefore of every- 
thing is carefully explained and the construction, manage- 
ment and manipulation of every kind of electrical apparatus 
and implement is thoroughly exemplified. After this has 
been accomplished, the subject of electro-therapeutics 
proper is taken up and is treated in the same masterly 
manner. Want of space will prevent us from saying what 
we would like in commendation of this work. But, we may 
best express our ideas by saying, that it is the first and only 
work of its character that we have ever seen, that fur- 
nished us exactly what we wanted on any and all subjects 
considered with electricity, electrical machines and electro- 
medicine and surgery. 



Moral (Affective) Insanity, 

On the above subject, Dr. C. H. Hughes, of St. Louis^ 
has an article in the Alienist and Neurologist, from which 
we extract the following paragraphs : 

"Consciously or unconsciously, they (the objectors to 
the theory of moral insanity,) reason it is not wise to re- 
cognize forms of insanity in which there appears a degree 
of responsibility ; hence, such insanity must not be accept- 
ed as an observed fact in science. 

"But what has the question of responsibility to do 
with a question of disease? and what if science should find 
a form of mental disease in which responsibility does really 
exist? Questions of responsibility belong to law; questions 
of disease to medicine. Law may find responsibility and 
testamentary capacity, where we physicians find disease, 
and it has found both co-existent with, sometimes much 
and sometimes little, disease of brain affecting the mind, 
but its conclusions do not change the facts of pathology. 
It is our duty to find out the facts, and so far as practicable 
in the nature of mental disease, to enlighten law as to the 
bearings of our facts on the legal question of responsibili- 
ty, but not to be blinded by it so that we can no longer 
see disease where it exists." 



Periscope and Abstract. 46- 

Erg-ot in Whooping- Cough. 

I am aware that in this disease a vast number ot rem- 
edies are useful, but after a pretty extensive trial, both in 
hospital and private practice, I believe ergot to be by far 
the best and safest. Up to the time when I began to use 
this drug I regarded the combination of bromide of potas- 
sium and tincture of belladonna, or sulphate of zinc and 
tincture of belladonna, as the best remedies with which I 
was acquainted, but they sometimes necessitated the bella- 
donna being pushed to its physiological action before the 
disease would yield. That was sometimes not unattended 
with danger in young children, unless they were carefully 
watched, which cannot be easily done in hospital or dis- 
pensary practice. 

I have now used ergot in whooping-cough for several 
years, and it seldom fails to cure in two or three weeks. 
The cases that are longer in getting better are those com- 
plicated with bronchitis or troublesome bronchial catarrh. 
I give from five to fifteen minims of the fluid extract every 
three or four hours, according to the age of the child, giv- 
ing a child three months old four or five drops every three 
or four hours, according to the severity of the cough. The 
benefit of the ergot is at once apparent, the fits of cough- 
ing occur less frequently and are not so severe when they 
do occur. I usually give it alone with a little sugar, or^ 
better still, with glycerine. Mixed with syrup it does not 
keep more than a couple of days, fermentation taking place. 
It may be combined with other remedies, especially with , 
the compound syrup of the phosphates, to complete the 
cure when there is debility. 

What is the action of ergot in whooping cough? We 
must regard the spasmodic cough as due to reflex action, 
and that in its turn is induced by the peculiar condition of 
the blood, irritating the peripheral ends of the sensory 
nerves. Ergot dulls or paralyzes these nerve ends, and sa 
lessens and eventually prevents the spasms. The true 
pathology of whooping-cough cannot now be considered 
doubtful, and most regard it as a germ disease. Only on 
that hypothesis can we explain its infectious nature. I do 
not here claim for ergot any specific power, but rather a 
physiological one. It may have a specific action, but of 
that I have no proof. However, of its power to cut short 
the disease there can be no doubt, whatever the theory of 
its action. This I have in hundreds of cases proved, nor is 
it necessary to give cases in detail, as all the cases would 
simply show a daily declension of the disease, till, at the 



46 The Peoria Medical Monthly. 

end of a fortnight or three weeks, the cough quite ceases. 
In some rare cases I have known the cough to return when 
the ergot has been left oif, so it may have to be continued 
for two or even three months; this, however, is the excep- 
tion. It may l)e given for months without producing any 
bad symptom. Under its action the appetite improves, as 
well as the general condition of the patient. On account 
of this tonic action I frequently give ergot in atonic and 
"enfeebled conditions so often met with in women where 
aiicPmia is associated with a weak .heart, inertia, etc. ^Dr. 
Allbutt has used it with great benefit in meii who are worn 
out from worry, and who need bracing up. I have a simi- 
lar experience. 

As this is a short practical paper I shall not enter into 
a further discussion ot the physiological action of ergot, 
suffice it to say that experimental and therapeutical evi- 
dence goes to prove that ergot has a sedative and not an 
irritant action. 

More important to the practical physician than how er- 
got acts is how is ergot prepared. Certain preparations are 
inert or nearly so, as the stale powder and the ordinary 
tincture. Alcoholic extracts are less powerful than aqueous 
ones. Most recent authorities agree with Dragendorff in 
regarding sclerotic acid as the active principle, and Ricitine 
in his experiments with sclerotic acid, has proved that acid 
to possess similar properties to ergot, especially the power 
of paralyzing the peripheral ends of the sensitive nerves. 
Kohler confirms this view. — TJierapeutic Gazette. 



Advice to the Medical Witness. 

The Transactions of the Orefjon State Medical Society/, 
1883, contains an able paper on Forensic Medicine by the 
President, Dr. C. C. Strong, of Portland, Oregon, from which 
we condense the following good advice to physicians who 
may be called upon to give medical testimony in the course 
of a jury trial. The writer insists first upon the most thor- 
ough preparation ; that the study of the case should be as 
complete as possible, as every opposing lawyer has 
"crammed" for the occasion, and will not fail to take ad- 
vantage of the slightest slip in the testimony of the wit- 
ness. It places a medical man in a very unpleasant posi- 
tion who comes into court from a half-performed post-mor- 
tem examination, satisfied l)ecause he has detected disease 
of the heart sufficient to cause death, if he is questioned 
whether or not there was fracture of the skull ; and if sub- 



Periscope and Abstract. 47 

sequent examination or testimony reveals that condition, 
of which he was ignorant, he loses professional standing 
which can never be recovered. Completeness of prepara- 
tion is necessary in all matters affecting public interest, not 
only for the advancement of justice, but for the vindica- 
tion of the witness. As an athlete, when called upon to 
perform some feat of physical strength, prepares his body 
for the task, so should the ph3^sician cultivate his intellec- 
tual power when notified of the probability of his being 
"questioned publicly by a law^yer. 

Let the preparation be methodical, and if possible, 
chronologically arrange the facts in the case. Be careful 
to refresh the memory just before, the trial as regards places, 
dates, names, and times ; and' when possible in naming a 
particular day, in the course of the testimony, it is well to 
give the reasons which impressed it upon the mind. 

Consider carefully beforehand size, weight, distance, 
when these are involved, using invariably their old English 
standards in mentioning them; and where proximate meas- 
ure only is required, be sure and refer to well known ar- 
ticles. There is nothing impressive, but the contrary, in 
referring to some professional standard generally unknown 
to the laity, unless it is necessary to make the testimony 
clear. If the witness is able to make some kind of a sketch 
showing the relation of a body, or portion of one, to its 
surroundings, his words can be much more plainly and 
definitely understood — but the sketch must be absolutely 
accurate. 

As an expert the physician will frequently be called 
upon for his opinion, and as his conclusions are to be de- 
duced from proven facts, they must be carefully drawn to 
possess any value. To perform this duty thoroughly he 
should therefore not wait until in the witness box. Tidy's 
advice may well apply at this point. He says : "And if in 
the quiet of your study you fail to come to a satisfactory 
conclusion, do not attempt a wild conjecture in the hurry 
and excitement of the witness box. To he accurate is ten 
thousand times better than to apjjear brilliant." 

The physician should carefully study the opinions held 
and expressed by others, and be able to give good definite 
reasons why he adopts some and rejects others, always re- 
membering that he will be exposed to the scathing fire of 
cross-examination. 

He should bear in mind the difference between a fact 
and an opinion so that there may be no confusion in his 
mind regarding their identity. For example, it is a fact 



48 The Peoria Medical Monthly. 

that certain drugs ai'e deadly poisons ; but their action in- 
producing certain effects is an opinion. The direction, size 
and character of a wound are facts. Deductions drawn as 
to the manner in which the wound was produced, or for 
w4iat purpose, is, in most cases, a matter of opinion. An 
opinion, however, is always based on facts, and either a- 
personal knowledge of the circumstances relating to these- 
facts, or knowledge gained from undisputed authority con- 
cerning them, is essential. No tolerance can be given to- 
hearsay or rumor. 

A biased statement given by a witness is invariably de- 
tected, and an attempt of the witness to arrogate to him- 
self any of the duties of the jury, injures the value of his 
evidence. 

The plainest English possible should be employed, and 
any tendency to exaggeration suppressed. Be sure before 
answering that the entire question is thoroughly under- 
stood, and the question alone asked should be answered 
without ambiguity or useless expressions. All "ifs" and 
"thats" should be omitted if possible, and the answers 
should convey real meaning in such clear, unmistakable 
language that there can be no misunderstanding. 

If no distinct opinion on a certain subject has been 
formed, there should be no hesitation in saying so; and the 
physician should never allow himself to be drawn into, or 
give, an opinion formed on the spur of the moment, in the 
witness box. 

As nearly as possible the exact language of conversa- 
tions testified to, or authorities quoted, should be given. 

When the close pressure of cross-examination occurs,, 
the only safety of the witness is in coolness, self-posses- 
sion, and a thorough knowledge of the case. If he los& 
his temper, he is sure to be led on until he irretrievably 
damages himself, his testimony, or his medical reputation. 

Admitted ignorance of a question not understood is not 
only not condemnatory, but praiseworthy ; and within cer- 
tain limits the answer, "I do not know" is both safe and 
honorable. 

A witness may be obliged' to answer yes or no in a given 
case ; but, though he may not modify it, he has a right to 
explain his answer so as to make it comprehensible, and he 
should always avail himself of that privilege, to prevent 
any chance of a misunderstanding of his meaning. All 
facts should be given as the witness understands them, 
without reference as to their effect, and in opinions drawn 
from facts if any honest doubts arise, they should be plainly 
stated. 



Periscope and Abstract. 49 

The witness should never allow himself to be drawn 
into a discussion ; but having given an opinion, and the 
reason for it, let it rest there. He is entitled to have the 
question fairly and clearly stated to him ; and the utmost 
care is required that the conditions of a hypothetical case 
should be plainly discerned and properly understood by 
him before answering. If the hypothetical case contains 
impossibilities, or inconsistencies, he should never endeavor 
to give a mixed answer, but insist that a proper case be 
given him. 

One of the most important points of all to be remem- 
bered is, that the opposing attorney will probably attempt 
to impair the value of important testimony given by the 
medical witness, by showing lack of professional knowl- 
edge, and will propound questions which are incapable of 
•definite answers, because of differences of opinion among 
high medical and legal authorities. The only manner by 
which such an attack can be met is to enter the courtroom 
prepared to state the existence of such differences, when 
they exist, and as they will probably relate either in a direct 
or remote manner to the subject of trial, the simple form 
of preparation is that recommended by Tidy, namely, get 
the case well up in your office before the trial. 



'The Value of the Electrolytic Method in Surgical Diseases. 

At the conclusion of an article upon this subject, read 
before the American Academy of Medicine, and published 
intheiVe^^' England Medical Monthly, December 15, 1883, 
Dr. A. D. Rockwell offers the following summary : 

1. The success to be met with in the treatment of ma- 
lignant growths in general is but trifling. The size is some- 
what reduced, and the pain is almost always greatly alle- 
Tiated. In the class of cases, however, termed epithelioma, 
when the disease does not extensively involve the subja- 
cent tissues, and where it is easily reached, it is probable 
that in the majority of cases the very best results will fol- 
low thorough and persistent treatment. 

2. Fibroids being dense and comparatively dry, do not 
readily shrink under electrolysis, and it is seldom that we 
can accomplish more than some slight diminution in bulk. 
The results following this limited influence, however, are 
especially valuable in the case of uterine flbroids of an in- 
tra mural character where the knife cannot be used. The 
pressure upon the bladder and rectum is in these cases 



50 The Peoria Medical Monthly. 

greatly lessened, or entirely dissipated, and the relief that 
follows is immense. 

3. It is in erectile and small cystic tumors that elec- 
trolysis is most effective. In these conditions it is indeed a 
specific. The cure that follows is complete, and with proper 
care scars can be avoided. 

4. The ordinary form of goitre acts somewhat capric- 
iously under electrolytic treatment. Goitres that are small 
and sott may not only be 'treated effectually by the intro- 
duction of needles, but external applications alone will 
sometimes cause them to entirely disappear. Even when 
they are quite large, if their density is not too great, a per- 
fect cure may follow. Where they do not entirely disap- 
pear they may almost invariably be reduced in size, afford- 
ing in many cases marked relief from the pressure that is- 
so distressing. 

5. By this method hairs may be permanently removed. 
The negative pole and a weak current are to be used. 

6. In many cases of urethral stricture permanent re- 
lief is afforded. A more extended experience, however, is 
necessary to establish its exact value. — Virginia Medical 
MontJdij. 



Administration of Salicylic Acid. 

The antipyretic effect of salicylic acid is one of the most 
remarkable and important therapeutical discoveries of our 
age, and its control over all such conditions as are gener- 
ally met with in acute and sub-acute rheumatism is almost 
complete. Its applications, therefore, in medicine aie very 
numerous and very important. In its internal use, the 
points necessary to be borne in mind are the very disturb- 
ing effects of very large doses, and the rapidity with which 
it is eliminated. It should, therefore, be given in full doses 
at first until the impression is made, and then in moderate 
or small doses, frequently repeated. It is best given in 
wafers or cachets, and it should not be packed in capsules. 
Two or three doses of fifteen to twenty grains, with two or 
three hours intervals, will usually produce its characteristic 
beneficial effects. Then ten grains every two hours with 
intervals gradually increasing to three and four hours, will 
serve to keep up the effects with the smallest risk of such 
disturbance as will require it to be suspended when most 
needed. Of late it has been rarely used, the salicylate of 
sodium having taken its place with the same effect, and 
with some advantages. It is a curious and very important 



Periscope and Abstract. 51. 

circumstance, that full doses of the acid or salicylate do not 
interfere with the digestive functions of the stomach, and 
yet a very small quantity will prevent the action of pepsin. 
At least this statement is made on what appears to be very 
good authority. An ordinary cold saturated solution con- 
tains somewhat about one part in 300 ; and such a solution 
is very convenient as a vehicle of solutions of alkaloids for 
hypodermic use. If a drachm of the acid be added to a pint 
of w^ater and the mixture well shaken, such a solution, with 
some undissolved acid at the bottom ot the bottle, will be 
the result. Then, if this be used entire, or diluted with an 
equal portion of water, for making hypodermic injections^ 
such a solution will remain free from growths of all kinds 
for an indefinite length of time, and will not be more irri- 
tant then when made from water alone.- — Sqiiibbs' Ephe- 
meris. 



The Treatment of Coug-h in Phthisis. 

Dr. T. Henry Green {Lancet) says : In treating the cough 
in phthisis it is in the first place to be remembered that the 
complete expectoration of the phthisical sputum is all im- 
portant, as its retention tends to cause infection of fresh 
portion of lung. Cough is therefore necessary, and, speak- 
ing generally, we may say that it should be interfered with 
by means of sedatives only with the object of procuring a. 
sufficient amount of sleep, and cough sedatives are there- 
fore admissible only during the night. I believe the old 
practice, and one still perhaps too frequently indulged in, 
of giving sedative cough mixtures during the day, or of 
combining sedatives with the tonic medicine, is much to be 
deprecated, for such treatment tends not only to interfere 
with the stomach functions, but also, in many cases, injur- 
iously to check the cough. The twofold cause of the cough 
must also be borne in mind, the irritation caused by the dis- 
eased lung and that caused by the pharynx and adjacent 
parts ; for, as pointed out by Dr. Lauder Brunton, the re- 
moval of one of these sources of irritation is often sufficient 
to prevent the reflex act. This explains the well-known 
fact that mucilaginous substances combined with the seda- 
tive render it so much more efficacious. The mucilage not 
only lubricates and shields the pharyngeal mucous mem- 
brane, but insures the local influence of the sedative. 
Practically, then, we may say that in attempting to control 
the cough in early phthisis, we should endeavor to influence 



52 The Peoria Medical Monthly. 

the pharnyx rather than the lung or the reflex center. 
■Some such combination as the following will in most cases 
■answer this purpose: Solution of hydrochlorate of morphia, 
-spirit of chloroform, and ipecacuanha w^ine, of each three 
minims : gum Arabic mucilage, twent}^ minims ; water to 
■one drachm. This, which should be swallowed slowly, may 
•be taken if necessar}^ three or four times during the night ; 
hut it should if possible be avoided during the day. Some 
demulcent drink or lozenge containing marsh-mallow, 
liquorice, etc., without opium, will usually serve sufficiently 
to restrain the day cough. A sedative inhalation the last 
thing at night, such as conium and chloroform, or a little 
opium, is another valuable mode of checking cough and 
procuring sleep, but is more frequently called for in the 
later stages of the disease. Opium in medium doses, bro- 
mides, and other drugs which influence the respiratory cen- 
ter, are rarely necessary in early phthisis. The importance 
ot promoting the early morning expectoration of the ac- 
cumulated secretion by means of some warm drinks we 
have already alluded to. The treatment of cough by in- 
halations we shall again consider presently. 



Aiitig-alactagogues. 

May I be permitted to add my testimony to the recent 
discussion in the Journal on the above subject.? In India 
women use belladonna as a household remedy, as an ex- 
ternal application over the breast when they wean babies, 
as an antigalactagogue. They generally keep in their 
houses round, flat, and smooth stones to make extracts, by 
rubbing on them roots, nuts, wood, bark, etc., of different 
medicinal agents, using water, spirits, etc., as media. In 
the case of })elladonna, they make a watery extract. I have 
seen it used as such with good effect. In my experience in 
cases of small-pox, where mothers were compelled to be 
separated from their babies, and where there was no hope 
of their return for weeks, I found a combination of five to 
ten grains of iodide of potassium, and five minims of tinct- 
ure of l)elladonna, for a dose, given every four hours, an- 
swer admirably well, and, on looking over my cases, I find 
I never was required to administer more than twelve doses. 
In some cases, ordinary adhesive plaster was applied to sup- 
port the breast, and, in a few painful cases, 1 used extract 
of belladonna and glycerine (1 to 8 strength) as an external 
application, with internal administration of iodide of po- 
tassium. In cases of threatening abscess, I have found a 



Periscope and Abstract. 53 

combination of iodide of potassium with cinchona a val- 
uable remedy. I may say that Indian women use the fresh 
leaves of datura and a species of stramonium as antiga- 
lactagogues, and castor-oil plant leaves as a galactagogue. — 
Dr. D. Makune, in British Medical Journal. 



dimination of Mercury During- and After its Cutaneous Em- 
ployment. 

Since the year 188 1, Dr. Schuster, of Aix-la-Chapelle 
{Journal of Venereal Disease), has made more than 100 ex- 
aminations regarding the elimination of mercury in syph- 
ilitics, who were either still under treatment by mercurial 
inunction, or had been so treated from one to twelve years. 
Most of the patients had used mercurial ointment for the 
inunctions ; in a few where examinations did not reveal 
traces of mercury in the urine, the drug was employed sub- 
cutaneously. In the urine, the writer states that he found 
mercury in small, rarely in large quantities, and not only 
during, but some weeks after the mercurial treatment. 
Often, however, the mercury was not found in the urine, 
either during or after the treatment. He concludes : — 1. 
Mercury is irregularly eliminated by the urine, — result al- 
ready pointed out by Vajda and Paschkis. 2. The mer- 
cury introduced by inunction either — (a) remains stored up 
in the organism ; or else — {b) it is secreted by some other 
channel. Schuster proceeded to the examination of the 
faeces, and found that mercury was always present in large 
quantities. The result of the forty fsecal examinations was 
as follows: — ^Mercury was found — 1. In relatively large 
quantities during the course of inunctions (earliest test 
ten days after the beginning of treatment). 2. Mercury 
was found in the faeces for five and a half months after the 
end of the course. Examinations made every ten to four- 
teen days. Mercury was found in the faeces in all the cases 
in which it was found in the urine ; jjer contra, it was often 
absent from the urine when present in the faeces. After 
prolonged courses of inunction, mercury w^as found in the 
faeces in such large amounts that it could have been deter- 
mined quantitatively. This second series of experiments 
shows clearly : The elimination of mercury by the faeces is 
regular, continuous. 2. The elimination of mercury after 
more extensive courses of inunction, say from thirty to for- 
ty-five days, is completed in six months. 3. Accordingly 
persistence of mercury in the system does not occur, — Med- 
cal Press*. 



54 The Peoria Medical Monthly. 

Guaiac in the Treatment of Acute Sore Throat. 

In a recent paper read before the Philadelphia Laryn- 
geal Society, Dr. Joseph B. Pottsdamer speaks highly of 
the action of guaiac in tonsillitis and j)haryngitis. He re- 
views the opinions of the various authorities on this use of 
the drug, and finds that by many of the leading writers on 
therapeutics it is not even mentioned, while others refer to 
it in terms of no very high praise. Phillips endorses its 
use very emphatically, declaring that given in half drachm 
doses (the tincture), every four hours, it appears to abate 
the inflammation and to cut short the disease in a remark- 
able manner. Morell Mackenzie and J. Solis Cohen warm- 
ly endorse its action. Dr. P. was first led to employ this 
treatment in 1879 'after he had had a succession of trials of 
it in his own case. In the winter of that year he was sub- 
ject to attacks of sore throat, which he found were prompt- 
ly aborted by the use of the tincture of guaiac, thus strong- 
ly corroborating Mackenzie's dictum, "that we have in 
guaiac a remedy which, if administered at the onset of the 
attack will almost always cut short the crescent inflamma- 
tion." 

The practical deductions which Dr. P. draws from the 
cases which have been under his treatment, are : 

1. The almost instantaneous relief from pain. 

2. The improvement in deglutition which always ac- 
companies this relief. 

3. The early diminution of the swelling. 

4. The short course of the disease, all of the cases 
having been practically well on the fourth day of treatment, 
if not sooner. 

5. If the case comes under the treatment early 
enough the disease may be aborted. 

Even if we agree with Trousseau and others in admit- 
ting that the disease must run its natural course, we have 
no right to, says Dr. P., to act supinely, as by the use of 
guaiacum we certainly ameliorate, and as he believes, cut 
short the disease. 



Knlarjfed Tonsils. 

Having frequently tried and often failed to cure en- 
larged tonsils by internal remedies, I at last hit upon the 
following surgical method of getting rid of these trouble- 
some glands, which I have pursued successfully for the last 
two or three years. 1 take a pencil of caustic potash,. 



Periscope and Abstract. 55 

whittle it down to a point, which I place upon the center 
of the tonsil and keep it firmly pressed there for about 
three seconds. Then w ithdraw it and gargle the mouth 
with vinegar. Repeat the operation twice or thrice a week, 
placing the pencil always in the same depression. I have 
cured the largest tonsils in less than one month. Having 
eradicated one, proceed the same way with the other. Ap- 
propriate internal remedies may be applied during the 
treatment. — Pittsburg Medical Journal. 



Quebracho in Asthma. 

Professor Da Costa has had some very satisfactory re- 
sults from the treatment of dyspnoea by quebracho. In a 
recent lecture he said that in his experience it had been es- 
pecially serviceable in two classes of cases. 

1. In purely nervous asthma he had found it to 'be in- 
valuable. 

2. In cases which have been rather loosely called car- 
diac asthma, cases in which a heart lesion has produced 
failure of cardiac contraction and consequent congestion of 
the lungs, he had also known it to be very useful. It may 
serve as a cardiac tonic, or may do good solely by its action 
on the respiratory centre in the medulla. Whatever be the 
explanation, however, quebracho gives relief in appropriate 
cases. Dr. Da Costa gives it in the form of the fluid ex- 
tract in doses of twenty minims every hour, gradually in- 
creasing the amount, some patients requiring as much as a. 
drachm before relief is obtained. The good effects are usual- 
ly observed after two or three doses have been taken. The 
taste is well covered by using equal quantities of French 
syrup of oranges and water as the vehicle, and in this 
form it usually agrees with the stomach. As the symptoms 
are relieved, the remedy may be given at longer intervals. — 
Boston Med. Jourfial. 



The Sensibility to Pain in New Born Infants. 

This is a question of considerable interest from various 
points of view, in addition to its interest as a physiological 
and psychological fact. In the hrst place it is of special im- 
portance relative to any operation which may be necessary 
in the early days of its existence ; then again it is of im- 
portance to the nurse, who, in the absence of this sensi- 
bility to pain, should increase her vigilance in reference to 



56 The Peoria Medical Monthly. 

external source of irritation. The Glasgow Medical Jour- 
nal quotes Genzmer on this general question of senses in 
new born infants as follows : 

The sense of touch is developed from the earliest 
period, and reflex actions are readily excited by the slight- 
est stimulation ot the nerves of touch, especially of the 
face, then of the hands, and soles of the feet. The feeling 
of pain is but slowly developed, and is only clearly exhib- 
ited after four or five weeks, before which time infants do 
not shed tears. True muscular sense is at least doubtful. 
Excitement of the sense of touch gives rise to unconscious 
reflex movements, the amount, therefore, rather than the 
quality of sensation is observable. Closure of the nostrils 
occasions a reflex dyspnoea. Hunger and thirst are mani- 
fested in an increased general irritability followed by re- 
flex movements ; these cease after the first week. Smell 
and taste are not distinguishable to infants. Genzmer as- 
serts, in opposition to Kussmaul, that the sense of hearing 
is perceptible in the first, or at most the second day of life. 
New born infants are so sensitive to light that they will 
turn the head to follow a mild light ; whilst if a strong 
glare be suddenly thrown upon the eye squinting is in- 
duced, and even convulsive closure of the lids. After a few 
days, the child will follow the motion of vaious objects 
by movements of its head. Between the fourth and fifth 
weeks the convergence of the pupils and the power ot co- 
ordination in vision are perceptible. A distinct perception 
ot color does not exist under four or five months ; before 
then it is quantity rather than quality of light that is 
recognized. The inhibitory reflex centre is not yet devel- 
oped in the eye ; weak and moderately strong irritation 
excite movements which serve that purpose. Excessively 
strong impressions only excite passive movements. New 
born infants cannot separate the impression on their or- 
gans of sense. The readiness of excitability is shown in 
the fact that the stronger the stimulation, the shorter the 
physiological interval. — Medical lievieiv. 



Eclecticism. 



In the April number of the Western Medical Reporter 
the editor attempts to define "eclecticism," as used in med- 
icine in this country, and after searching the writers era- 
braced in that so-called "school" or "sect" without being 
able to come to any definite opinion, concludes with the 



Periscope and Abstract. 57 

expression of one of the ablest writers and acknowledged 
leaders of the Electic School, as follows: 

"Eclectics constitute a strange medley — they form a. 
mosaic of more colors than Joseph's coat. 

"They entertain many shades of opinion, and agree 
chiefly in claiming individual independence. Each wants 
to be let alone, and each protests against restraint ; hence 
we are brittle material from which to weave a firm 
fabric." w. 



Atrophic Nasal Catarrh. 

In a clinical lecture by Dr. Carl Seller, published in the^ 
Medical and Surgical Reporter of April 19, the above sub- 
ject is treated of in a very practical manner. After defin- 
ing the term as applicable to those cases characterized 
chiefly by a peculiar penetrating odor, and incorrectly 
termed "oezena" by the older writers, the lecturer exhibited 
a typical case with dry and shiny posterior wall of pharnyx, 
without elevation or enlargement of follicles and glands as 
in ordinary form of catarrh, and the naso-pharyngeal cav- 
ity lined with large scabs of hardened secretion, and con- 
cludes with the following in regard to the treatment: 

" The treatment for atrophic nasal catarrh must be di- 
vided into two portion^'s, viz : The removal of the accumu- 
lation of secretion and the disinfection of the nasal cavi- 
ties to remove the odor, and the stimulation of the mucous 
membrane, with a view to the regeneration of the serous 
glands. 

"This may be accomplished in the following manner :. 
The nasal cavities are first cleansed with a copious stream, 
of alkaline solution from the nasal douche, and let me tell 
you here that this is the class of cases in which this much- 
abused instrument is not only appreciable, but extremely 
useful without being harmful. If after this, any plugs re- 
main in the nasal cavities, they must be removed with a 
pair of forceps, and the washing repeated until all secre- 
tion has been removed, as you saw me do in the case before 
us. The next step is to disinfect the nasal cavities. Various 
substances have been used for this purpose, such as per- 
manganate of potash, chlorine water, tar water, carbolic 
acid solution, iodoform, and many others; but they all have 
either great disadvantages, or else are but partially effect- 
ual. Lately I have used a preparation called listerine, 
which answers the purpose admirably, without having any 
of the disadvantages of other disinfectants. It is a com- 



58 The Peoria Medical Monthly. 

bination of the essential oils of thyme, eucalyptus, gaul- 
theria, and other plants, together with a small quantity of 
benzo-boracic acid, and should be diluted one-half with 
water when used by the atomizer. The immediate effect 
is to at once destroy the starch from the nose, and to sub- 
stitute for it the odor of the oil of thyme, which is rather 
pleasant than otherwise. I am in the habit of using a spray 
of this solution before making an examination, or before I 
cleanse the nasal cavities of such cases, thus mitigating 
very materially the discomfort to myself arising from the 
stench. The patient is directed to cleanse his nose with a 
solution of two drachms of bicarbonate of soda to one 
quart of tepid water morning and evening, and to throw a 
spray of the listerine solution into the nostrils after the 
cleansing. Treated in this manner, 1 have seen many cases 
in which the odor was barely perceptible after the lapse of 
three or four days, and remainerl in abeyance throughout 
the treatment. The oil of thyme and of eucalyptus, be- 
sides being disinfectants, have also a stimulating effect 
upon the mucous membrane, and thus aid in the second 
portion of the treatment. 

'"The stimulation of tile serous giands to a normal ac- 
tion may be brought about by a variety of remedies, such 
as astringents in various strength ; but in my experience 
the insufflation into the anterior nasal cavities of finely 
powdered nitrate of silver, diluted with starch powder, has 
given the best results. Where there is complete absence 
of the lower turbinated bones, the introduction of a wad 
of absorbent cotton, which is to remain until washed out, 
and then be reintroduced by the patient himself^ often aids 
in the stimulation by continually irritating the mucous 
surface with which it is contact. Next in effectiveness to 
the silver powders, I have found a weak solution of ferric 
alum in the form of a spray thrown into the nasal cavities, 
and the natural iron water of Cresson springs is peculiarly 
adapted for these cases. 

"A treatment such as this carried out for several 
months has given, in my hands, most satisfactory results. 

"The internal administration of small doses of bromide 
and iodide of potassium in combination, on account of 
their influence upon the nasal mucous membrane, will 
greatly aid the local treatnient. At the same time we must 
look to the general health of the patient, and administer 
when their use is indicated. Whenever practicable, a 
change of air should be advised, and the mountain resorts 



Periscope and Abstfact. 59 

are preferable to the seashore in all cases of catarrhal in- 
flammation of the upper air passages, especially when the 
climate is a dry one." w. 



Iron Hypoderinically iii Aiisemia. 

Dr. J. M. Da Costa has been using hypodermic injec- 
tions of iron with good results in a case of combined mala- 
rial poisoning and lardaceous disease ot the viscera. He 
prefers a double salt produced by the addition of pyro- 
phosphate of iron to a solution of citrate of sodium. Two 
grains of the salt, in this form, are given every day, vary- 
ing the points of puncture, but generally administering it 
under the skin of the extremities ; in this form no ab- 
scesses have been observed. With other solutions of iron, 
including dialyzed iron, abscesses were quite common even 
with every precaution as to cleanliness of the syringe. 



Septicemia aud Lacerated Cervix. * 

In a communication to the American Journal of Ob- 
stetrics for April Dr. Wm. W. Seymour, of Troy, N. Y., de- 
tails the history of a couple of cases of laceration of the 
cervix uteri at a point nearly on a level with the os inter- 
mum, and extending into the right broad ligament, fol- 
low^ed' by hematoma and septicemia. In the first case death 
followed suppuration and a post mortem examination re- 
vealed a communication of the pus cavity with the bowel. 

The reporter has been able to find recorded only one 
case of hematoma occurring during labor, and nowhere 
any reference to these peculiar lacerations extending into 
the broad ligament. He says these cases cannot be recog- 
nized without a careful examination with the sound, and 
that they "are doubtless commonly the source of septic- 
emia in cases where the source of infection is held to be 
slight vaginal, perineal, or intra-vaginal lacerations of the 
cervix." 

In the cases reported intra-uterine injections of hot so- 

, lution of chlorinated soda were used, m the first instance 

followed by chills, which he regards as of nervous origin, 

and not due to the absorption of septic matters. The 

writer concludes with the following summary : 

1. "Until the cervix is fully dilated, the presenting 
part must be kept back and the cervix supported to pre- 



60 The Peoria Medical Monthly. 

vent its laceration by the presenting part or the after-com- 
ing shoulders. 

2. Hot water injections will, immediately after deliv- 
ery, make laceration of cervix and vagina patent which 
otherwise would not be discovered by the touch for several 
days. 

3. In every case of suspected cervical laceration, a 
careful search should be made with the uterine sound for 
supra-vaginal cervical lacerations. 

4. Large doses of quinine, 20 or 25 minutes prior to 
the uterine injection, will prevent chill and probably also 
uterine colic. 

5. A supra-vaginal laceration of the cervix should be 
treated by the armed probe and irrigation. 

6. Examination within the first few days after labor 
would probably show a fair percentage of peri-uterine hem- 
atoma from laceration." w. 



Mullein Plant in Phthisis. 

We recently noted that Dr. F. B. Quinlan had reported 
a considerable increase in weight in a patient in the pre- 
tubercular stage of phthisis under the use of mullein. We 
find a supplemental note in the Brit. Med. Journal, Jan- 
uary 5, 1SS4, from which we learn that this same patient 
only gained seven pounds eight ounces under the use of 
cod-liver oil, in the same space of time in which she had 
gained twelve pounds eight ounces under mullein. Her 
cure was complete, and the respiration over both lungs is 
normal. 



How to Hold the Laryngoscopic Mirror. 

Don't hold your mirror as you would a cart whip; hold 
it as you would a pen and pass it over the extended tongue 
without hitting that sensitive organ. If you scrape the 
tongue with the mirror, ten to one, your patient will gag. 
When you get it beyond the tongue, lift the uvula gently 
on the mirror, and you will be almost sure to see the re- 
flection of the epiglottis and more or less of the larynx. 
A gentle motion of the mirror toward one side or the other, 
or forward or Ijackward, will enlarge the field of vision 
correspondingly. — Polyclinic. 



The honorary degree of Doctor of Laws has been con- 
ferred upon Dr. Fordyce Barker by the Edinburgh Uni- 
versity. 



Therapeutic Notes. 



61 



ANTI-SPASMODIC MIXTURE. 

The following is taken from the Ger- 
man Pharmacopoeia. It is much used 
as an antispasmodic in hysteria: 
Ij Tr. assafanidse • % oz. 

Tr. castorei 3^^ oz. 

Tr. opii 1 dr. 

M. Dose, from fifteen minims to 
one-half a drachm, to be given as requir- 
ed. The dose may be increased when 
the siezuies are ot great intensity. — 
Med. and Surg. Reporter. 

GONORRHCEA INJECTION, 

This sedative and antiseptic injec- 
tion may be used even in the acute 
stage with good results. It is claimed 
to be superior to any other single in- 
jection : 
5 Pulv. iodoformi 20 parts. 

Acid carbolic! 10 parts. 

Glycerini 80 parts. 

Aquae distil. 200 parts.M 

GONORRHCEA INJECTION. 

5 Hydrarg. bichlor ^ gr. 

Mucil. acacise 1 oz. 

Aquae distil., q.s. ad. 4 oz.M 

Sig. Two syringefuls just after each 
urination. — Texas Courier of Medicine. 

ECZEMA OP THE GENITALIA. 

5 Chlorate of potassium 30 gr. 

Wine of opium 50 gr. 

Pure water 1 pt. 

Apply to the parts by linen compres- 
ses covered by oiled silk, if there is 
much inflamation precede this with 
warm hip-baths and cataplasms, sprinkl- 
ed "with powdered carbonate of lime. 
— Obstetric Gazette. 

LUCORRHOEA. 

In fetid leucorrhoea one to five tea- 
spoonsful of the following in a quart of 
of warm water to be injected two or 
three times a day : 
g White vinegar (or wine) 300 parts. 

Tinct. of eucalyptus 45 parts. 

Salicylic acid 1 part. 

Salicylate ef sodium 20 parts. 

Mix. — Obstetric Gazette. 

ABORTION. 

Prof. Parvin says that the best mode 
of giving opium to prevent abortion is 
by the rectum. He gives from twenty 
to thirty drops of laudanum, and re- 
peats it as often as necessary. 



WHOOPING COUGH. 

Dr. H. Cullimore in the Brit. Med. 
Journal says, alum is the best remedy 
for this disease. The following pre- 
scription may be commenced as soon. 
as the distinctive cough appears: 
5 Aluminis sulph 2 grs. 

Tr. belladonnas 3 to 5 grs. 

Tr. cinchonae 12 min.. 

Sys. aurantii % ^^■ 

Aquam, q.s., ad. 2 drs. 

M. This amount is given three or 
four times a day to a child four years 
old. — Canada Lancet. 

DYSPEPSIA. 

9 Jensen's pepsin 192 grs. 

Sherry wine • 6)4 ozs. 

Glycerine, pure \}4 ozs. 

Tartaric acid 5 grs. 
M. Sig. One teaspoontul to be giv- 
en after each meal. — Med. and ISurg, 
Reporter. 

NEURALGIA-CHOREA. 



3 Ex. hyoscyami 
Ferri valerianatis 



i^dr. 
Idr. 



M. Divide into 30 pills and give- 
one pill three times a day. This is al- 
so an excellent anti-spasmodic and tonic 
and may be employed with great ad- 
vantage in chorea. — Med. World. 

NERVOUS PROSTBATIOK. 

Phosphoric acid, dil. 1 oz. 

Elix. calisaya 4 oz«. 

Elix. valer, ammon. 3 ozs. 

Glycerine 3 ozs. 

Sherry wine to make 1 pint. 
M. Sig. One to two teaspoonsful 
three or four times a day. — Med. World. 

OVARIAN DYSMENORRHfEA. 

Dr. N. S. Davis recommends the knee 
and chest position three or four time& 
daily, for a few minutes, and in con- 
junction prescribes: 
5 Ammon. hydrochlor 3 drs. 

Tr. strammonii % oz. 

Tr. cimicifugce, rad. 1)4, oz. 

Syr. glycyrrhizse 2 ozs. 

M. Si^. Teaspoonful 3 times a day. 
Dr. Wm. Goodell uses the following 
combination : 
5I Zinci valerianatis, 
Quinise valerianatis, 
Ferri valeriantis, aa. 20 grs. 

M. et. div. in pil. no. 20. Sig. one 
pill three times a day. — Dr. James 
Egan in Med. World. 



Peoria Medical Monthly. 

THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

•204 South-JeflFerson Street, .... PEOKIA. ILL 

♦«*The Editor is not responsible for the statenaents or opinions of contributors 

***Short orisrinal articles are invited from any reader, whether a subscriber or not. 

***If extra copies are desired by a contributor, the number must be specified when 
the article is sent in to the Editor. 

#♦* All exchanges, books for review, and communications naust be addressed to the 
Editor and Publisher. 

***The publication day of thi.s journal is on or about the 15th of each month. 

***To subscribers ! A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requested. 



Etherization by the Rectum. 

The Medical Record of April 26th first brought this sub- 
ject before the profession in America, so far is known to us, 
by an abstract from the Lijon Medicale, in which Dr. Mol- 
liere fully described this, certainly novel, method of obtain- 
ing anaesthesia. 

It is obtained by immersing a bottle containing the 
ether in water of 120^-140^. From the mouth of the 
bottle extends a rubber tube (of length to suit) which ends 
in a common nozzle, tor insertion into the rectum. 

Strange as it may appear at first glance, anaesthesia is 
thus produced almost, if not fully, as rapidly as by inhala- 
tion. 

Molliere reported its use in half a dozen cases in which 
it was very successful, and he claims that it will prove a 
procedure of great service. He says: "It suppresses the 
period of excitation ; it permits one to regulate the dosage 
rerj exactly ; it reduces the amount of ether needed ; it 
permits of operations .upon the face ; and it is more agree- 
able to patients." 

The Record of May 3d contains several articles upon 
this subject : one by Dr. Wm. T. Bull, in which he tabulates 
aerenteen cases in which ether was administered by the 
rectum. The time required to attain complete anaesthesia 



Editorial Department. 63 

Taried from five to twenty-five minutes. Vomiting occurred 
in six cases during its administration, but was slight and 
generally not repeated. The stage of excitement seemed 
shortened, or was entirely absent. Seven patients had di- 
arrhoea following, and in two cases blood was passed with 
the discharges. In conclusion. Dr. Bull believes it a valu- 
able addition, but not destined to supplant etherization by 
inhalation ; and he considers it a dangerous irritant to the 
bowels. 

In the same issue of the Record, Dr. R. F. Wier reports 
the death of a patient a few hours after rectal administra- 
tion of ether. The case was that of a robust child, aged 
eight months, operated on for hare-lip. Cause of death, in- 
testinal hemorrhage. This confirms Dr. Bull's opinion that 
it is not without great danger from this source, and that it 
-ought not to be used in young or enfeebled subjects* 

It is probable that the subject will receive thorough 
trial, and its merits be fully established before long. In 
the mean time we believe it to be a method that will not 
•bear reckless experiments. 



The Authority of Experience and Common Sense. 

A remark made in the course of a medical discussion 
ty a practitioner of many years' experience, led to some 
thinking on our part. He said: "When men of intelli- 
gence, education, and endowed with good powers of obser- 
vation, have practiced medicine conscientiously for some 
years, their dicta in medical matters should be received as 
equal authority, or as better authority, than the writings of 
many who give us volumes full of what we must or must 
not believe or do." 

Too many physicians, especially young physicians, lend 
a willing ear to those only, whose names are widely adver- 
tised as professors and authors ; they consider their old, 
gray-haired neighbor a fogy and behind the times, when, 
were the truth known, that unkempt, old head, covered by 
that old slouch hat, contains more practical, solid medical 
knowledge than half a dozen elegant college professors. 



64 The Peoria Medical Monthly. 

He treats his patients ; they treat the disease as they 
understand it to be ; his whole aim is to relieve suffering- 
and save life, their aim, too often, is to test a preconceived 
theory of treatment, even if the patient does suffer. But 
stop! we did not intend to run into comparisons, but mere- 
ly to give credit to the general practitioner for what he 
has done, and claim for his utterances (alas! they are too 
few) the authority ot experience and common sense. 



A Xew Department: Our Clinical Society. Will It Succeed? 

* Yes, if you will take hold of it and use it, as you. 
should use anything that will be to your own advantage. 

The medical profession has theories enough and to- 
spare. What it wants now are facts — simple facts — by 
which theories may be established or overthrown. This 
recording of facts, clinical facts, is one of the greatest im- 
portance, and we need scarcely add, of the greatest interest 
to the physician. We have frequently asked our friends ta 
report cases for this journal, and the fact that they have so- 
liberally done so in the past, may explain a large propor- 
tion of its popularity and usefulness. How we can increase^ 
this usefulness is to us a matter of study. We have no- 
ticed that reports of clinical societies are perhaps the most- 
popular, and it occurred to us that our readers might take 
kindly to the idea of starting a clinical society of their 
own ; one in which every member will have an opportun- 
ity to be heard, and, better yet, to be read by a much larger 
number than could possibly hear his voice. It is perhaps 
needless to repeat the old argument that every physician 
has cases that would be of great interest and value to the 
profession if duly reported, and it is also unnecessary to 
more than remind our readers that the general practi- 
tioner, and especially the country practitioner, meets with 
as important, as interesting and as rare cases as the great- 
est professor m the land. This being true, the conclusion 
is plain that it is the duty of the physician to his profession 
and humanity to record these facts, and make them profit- 
able to all. Hence, the beginning of " Our Clinical Society.^'' 



Editorial Department. 65 

We offer our services as recording secretary, and will try 
and see to it that all are heard. Letr any physician adopt 
this journal as his record-book of important cases for a 
time, and he will be a gainer by it ; he will learn to be 
more accurate in observation, more experienced in con- 
densation, and he will have a printed history of his cases 
for future reference. This is only the benefit our plan 
would be to the individual. How much gjreater would be 
the benefit to every reader to have the record of ten, — 
twenty, — perhaps fifty cases laid before him each month? 
The only request we make is, he brief as possible ; and let us 
have next month a good attendance at our first regular 
meeting. 



Obituary. 

Willard Parker, M. D., L.L. D., one of the most distin- 
guished practitioners and teachers of the century, died 
April 25, 1884. 

He was born in New Hampshire in 1800, and graduat- 
'Sd from Harvard in medicine in 1830. He held several 
Professorships of Surgery at various times, in the Berkshire 
Medical College, the Cincinnati Medical College and the 
College of Physicians and Surgeons, New York City. 

Dr. Parker was a general practitioner, although for 
many years he did the leading surgical practice in New 
York. He was a teacher rather than a writer and his pub- 
lished writings are very few. 

Samuel D. Gross, M. D., L.L. D., D. C. L., etc., etc;, the 
greatest surgical authority America has yet produced, died 
May 6, 1884. 

He was born in Pennsylvania, July 8, 1805, and gradu- 
ated from Jefferson Medical College in 1828. The history 
of his life would be too long to even epitomize here. His 
body was cremated at Washington, Pa., on the 8th inst. 

Within the past few months death has robbed our pro- 
fession of three of its most brilliant members — Sims — 
Parker— and now, last and greatest of all. Gross — but their 
names and example will live to cheer and encourage the 
struggling practitioner for years to come. 



66 The Peoria Medical Monthly. 

Receipts. 

To save the time and expense requisite for sending a 
formal receipt to subscribers, we have for some months 
past adopted the plan of printing in this place the names 
of those from whom money has been received during the 
preceding month. Those remitting will please note 
whether their names are included in the lists, and if they 
are not will notify them by card : 

Illinois— Drs. W. H. Reedy, D. E. Thomas, G. G. Craig, H. M. 
Leeds, Thos. O. Miller, T. J. Garrett, J. C. Cook, Geo. A. Smith, Wm. 
A. Hickman, C. S. Dickson, A. W. Hurd, Green Hill, G. M. Blackburn 
(2 years,) Horace Wardner, L. A. Fisher, W. H. Conibear,M. F. Rolens, 
T. A. Scott, Geo. Schloetzer,- Jno. Ten Brook, J. J. McKibben, P. McElr 
vain, R. Sager, E. H. Keith, P. T. Leeds, F. J. Nye (2 years.) 

Nebraska— Drs. C Schenck, S. W. Dodge, Thos. H. Line, O. O. 
Reynolds. 

Iowa — Drs. J. Gamble, H. L. Cokenower, C. S. Stroud, H. Lindner,. 
"W. T. Cobb, J. D. Elliott, Adam Ramsey, J. A. Scroggs (2 years.) 

Kentucky — Dr. J. J. Rodman. 

Minnesota — Drs. A. F. Whitman (2 years,) D. W. Bolles. 

Kansas— Drs. A. Puderbaugh (2 years,) Hoover & Porter, O. L^ 
Young. 

Texas— Dr. W. W. Woodward. 

Wisconsin- Drs. C. W. Stoelting, J. F. Corbett, L T. Branch. 

Ohio — Drs. J. L. Lane, J. H. Day, G. R. Hagerman. 

New York— Dr. L. F. Daggett. 

Indiana — Dr. P. M. Cook. 

Connecticut — Dr. Chas. D. Alton. 



Notes and Comments. 

How do you like the size of this issue ? 

A movement is on foot to establish a hospital for chil- 
dren in St. Louis. 

The British Parliament has refused to pass the bill to 
license crematories. 

The International Medical Congress will convene at 
Copenhagen on August 2, 1884. 

Pay up your dues, and make, this size a permanent 
thing. You will be the gainer by it. 



Editorial Department. 67 

Dr. E. B. Stevens has retired from the editorship of th» 
Obstetric Gazette. Dr. J. C. Culbertson succeeds him. 

Dr. Wm. B. Atkinson has taken to himself a wife. 
Hosts will tender their congratulations to the genial secre- 
tary of the American Medical Association. 

Oliver Wendell Holmes says that the great secret of 
success in every form of quackery is hope kept alive in the 
patient ; while the too fatal gift of science is a prognosis of 
despair. 

A bill has been introduced into the House of Commons 
providing for the restriction of the sale of patented medi- 
cines until they have been officially analyzed and pro- 
nounced not poisonous. 

A case is reported in which the Supreme Court held 
that when a doctor sold out his practice " in a city and its 
vicinity," that all space was included within ten miles of 
the city, or its corporate limits. 

Le Blond and Fissiaux recommend resorcin for chan- 
croids in woman. It acts more quickly than iodoform and 
has not such a disagreeable odor ; it may be used in pow- 
der or in 25 per cent, solution. 

Dr. Chas T. Hunter, a prominent physician and demon- 
strator of anatomy in the University of Pennsylvania, died 
on April 27th, with septicaemia, the result of a dissecting- 
room cut inflicted upon one of his fingers. 

Mr. John Jacob Astor, of New York, has given $200,- 
000 to the N. Y. Cancer Hospital, which assures the suc- 
cess of this institution, which is the first hospital founded 
exclusively for cancer patients in this country, 

" There is nothing very brilliant about our Bremerii 
dentists," said a lady to a member of the profession in Ber- 
lin, " but they are very obliging. If you wish a tooth ex- 
tracted with gas, they forthwith light the chandelier." 

A curious suit has been entered at Washington for 
trial. A gentleman has sued his family physician, asking 
a thousand dollars for malpractice, the cause being that the? 



68 The Peoria Medical Monthly. 

latter tailed to prevent the spread of contagious diseases in 
the family. 

Puck defines an ear-ring as a convention of otologists. 
The Medical Age asks : "Would it call- a dentist a tooth- 
pick .?" — Canadian Practitioner. Or a lithotomist a stone- 
cutter ? — New Eng. Med. MonthUj. Or an orthopBgdist a foot- 
pad ? Next! 

The American Psychological Journal gives the following 
definition of insanitj^ by a man who was asked why he 
thought his wife was crazy. He said: "Her head gets 
twisted up with ideas, and then she gets mad at her own 
thoughts and fights it out with somebody else." 

The Medical Department of the University of Nebras- 
ka has fourteen professors. Eight are called regulars, three 
are termed Homeopaths and three are called Eclectics. 
They have had lively times during the past term, if we are 
to credit the JonrnaVs statements. Fire and gunpowder 
explode when mixed. — Detroit Lancet. 

Dr. Holmes, some years ago, wrote as foUow^s to a 
young man who requested his advice about becoming a 
doctor: "My dear young friend: To be a physician, the 
following requisites, if not absolutely necessary, are very 
desirable : First, a sound constitution. The wear and tear 
are very great ; broken rest, irregular meals and exposure 
of all kinds demand great stamina. Second, an unselfish 
nature. You must always think of your patient's welfare, 
not of your own welfare or habits. Third, you must be con- 
tent to wait a long time before you establish a paying rep- 
utation. Fourth, much of your work being distasteful, 
vv^earisome, wearing to the body and almost fruitless to the 
mind, you must gradually harden yourself to the routine, 
and for this you ought to have an easy and accommodat- 
ing temper. Fifth, you must he in constant familiarity with 
suffering of all kinds, which must either make your feelings 
tough or keep you in distress. Medicine is very exacting. 
I don't believe much in literary doctors. I would not have 
one who was in the habit of scribbling verse, or stories, or 
anything of thQ kind." — Medical Record. 



The Peoria 
MEDICAL MONTHLY. 



Vol. V. JUNE, 1884. No. 2. 



0ri0lttal cmcmmuttiatiouisi. 



Art. I.— Retro-version of the Uterus. By H. Fitzgibbon, M. D., M. R. C, S., M. 
R. C. P., Medical officer to the Parish for the Poor, London, England. 

Retro- version of the uterus is one of the most common 
forms of displacement of that organ, as well as one of the 
most difficult to retain in position after it has been reduced. 
At first thought, the reader may think the above statement 
erroneous, for prolapse is usually supposed to be the most 
common uterine displacement; but when we remember that 
in order to become prolapsed the organ must first become 
retroverted, it is easy to see that the statement is quite 
correct. As long as the uterus retains its normal position 
of a right angle, (or very nearly that, as it varies in health 
from 20 to 35 degrees, as the bladder is full or empty) to 
the vagina it is impossible for it to become prolapsed. 
•Of course a normal vagina, or one corresponding to a line 
■drawn from the symphysis pubis to a point just below the 
promontory of the sacrum is refered to, for an abnormal 
vagina, or one with its outlet a lacerated perinenum would 
not meet the uterus at anj^thing like its normal angle. 
Strictly speaking then, prolapse and retro-version are 
synonymous, for one cannot exist without the other, hence 
they are one displacement and any distinction is but an 
arbitrary one. Nearly all the pessaries ever invented have 



70 The Peoria Medical Monthly. 

been constructed to correct a displacement but imperfectly 
understood, hence their principle of application has been 
more or less wrong, and the results often negative. For 
twenty years I have treated uterine displacements with but 
indifferent results, sometimes my patients were benefited 
and sometimes my treatment resulted in giving but little 
satisfaction to either them or myself, notwithstanding 1 
have endeavored to.keep abreast of the times upon the best 
methods of treatment. With these facts before- me I had 
come to believe with J. Mathews Duncan, that the best 
pessary for retaining a displaced uterus, was "no pessary.'^ 
Two years ago I took a vacation, spending the time in 
the United States, and seeing the wonders of the new world. 
While there I naturally visited all the medical colleges on 
my route, and while in Cincinnati or Louisville, I do not 
remember which, 1 heard a short talk or lecture one after- 
noon which quite changed my views upon the application of 
pessaries and the theory of certain uterine displacements. 
Until then I had looked upon retro-version as a separate 
and distinct form of displacement, instead of viewing it as- 
a degree of prolcqjse. The physician who put forth these 
views in his lecture, was Dr. Herrick the inventor of the 
pessary bearing his name, and like myself was a visitor at 
the college, having called as he was passing through the 
city. We were both called upon for some remarks to the 
class, and he gave a short talk upon uterine displacements. 
I do not know whether his remarks awakened any particu- 
lar interest in the others present, but the ideas advanced 
were certainly new to me, and threw some light on the 
subject that I had considered thoroughly canvassed and 
worn out. Since then I have acted upon the principles 
he laid down in the treatment of my cases, and with the 
most gratifying results. I know that it is generally thought 
in America that an Englishman thinks himself incapable 
of being instructed by Yankees, but if there is any such 
feeling among other English visitors, I am surely an excep- 
tion for I did learn something while there. The theory 
the doctor advanced was that, as before stated, retro-ver- 
sion was but a degree of prolapse, and that the uterus in 



Original Communications. 71 

becoming prolapsed followed the bony straits exactly as 
does the head of a child during partupition, and that as 
soon as the uterus become prolapsed far enough for the os 
and cervix to get well into the inferior strait, the fundus 
must fall backward and become retro-verted, and the 
greater the degree of prolapse the more the uterus would 
be retro- verted, for the uterus in coming down must follow 
the axis of the pelvis, until when the os protrudes at the 
vaginal outlet, the fundus must lay in a retro-verted posi- 
tion in the hollow of the sacrum. A little study of the 
anatomy of the female pelvic cavity will convince any 
one, as it did me, that he is right; it cannot be otherwise, 
and I only wonder now that I had not seen it before. 
The method he advocated of treating displacements was 
in line with the theory; and instead of adjusting a pessary 
to push forward on thQ fundus of the uterus, he proposed to 
adjust one to push upward and backward on the os and cervix 
letting the fundus take care of itself, for with the os and 
ceroix held back into the hollow or just under the promon- 
tory of the sacrum the fundus cannot do otherwise than 
stay forward where it belongs. Dr. H., showed a pessary 
invented for the purpose, and which the reader is doubtless' 
familiar with. Since coming home I have put these ideas 
into practice and with results which I never before ob- 
tained. I now always succeed in holding the uterus in 
its proper place, instead of as before, only succeeding in, 
perhaps, less than half my cases. And the reason for my 
former failures was that I placed my pessaries so as to 
make pressure upon the wrong side of the uterus, instead 
of pushing the organ upward, and backward, the pessaries 
were so placed as to push forward on the fundus and more 
or less downward on the whole organ ; this often defeating 
my object, as hundreds of pessaries are still placed. I have 
used many of Dr. Herricks pessaries and think them quite 
superior to anything I know of; their only objection being 
the attachment to a belt, some patients will not wear the 
belt, etc , long enough to get well, as they dislike the rubber 
tubes presence constantly between the legs ; but the outside 
attachment makes the instrument more effective if the 



72 The Peoria Medical Monthly. 

patients will make up their minds to wear it. I have used 
the ring and stem without a belt in some cases with good 
result, but unless a bandage is worn over the vulva they 
are likely to slip down when not attached to a belt. In 
some cases I have remodeled a Hodges closed lever pessary, 
curving in one end and letting it rest against the anterior 
portion of the uterine neck; this works very well only it 
must be watched to keep it in position. I have also used a 
Thomas retroflexion pessary, by giving it sufficient curve to 
make it rest against the anterior neck instead of behind it, 
as the pessary is intended. In a similar manner I have 
used a number of different kinds, among them some of our 
English pessaries, remodeling them to suit the purpose ; 
but when a patient will wear it long enough to effect a 
cure, I prefer the soft rubber and silver wire pessary, inven- 
ted for the purpose. The main point however, is to apply 
the mechanical support where it belongs, if that is done it 
matters very little what pessary is used. A very simple 
test of the correctness of the theory advanced above, is 
after a prolapsed and retro-verted uterus has been replaced, 
to place the finger against the front of the uterine neck, then 
let the patient assume several different positions whileyou 
still hold the uterus upward and backward by pressure 
against the os ; as long as you hold your finger there, the 
uterus will stay exactly in place ; now what is wanted is a 
mechanical support that will take the place of the fiuger 
after it is removed ; and any pessary fashioned to do that, 
will be effective, and will answer the purpose. 



AitT. II.— The Use of Antiseptics in Obstetric Practice. By H. S. Bell, M. D., 
Paris, 111. Read l)efore the ^sculapian Society of the Wabash Valley at 
Terre Haute, Ind., May 14, 1884. 

The use of Antiseptics in Obstetric practice is perhaps 
attracting more attention at the present moment, from the 
medical profession l:)oth ,at home and abroad, than any 
other important su])ject. And in discharge of the duty of 
reporting upon obstetrics, I shall invite a discussion from 
the society upon this fertile topic. 

Antiseptic surgery, first systematized and put into 



Original Communications. 73 

practical use by Sir Joseph Lister, of Edinburgh, in 1867, 
has rapidly found favor with the majority of the best sur- 
geons. 

In fact with almost all who have without predjudice, 
put it to the test of experience, the result of this practice 
has in this short time relieved surgery of many of its bit- 
ter disappointments and therefore made its practice de- 
lightfully seductive and correspondingly profitable. 

The praises of McDowell, of Kentucky, of Sir Spencer 
Wells, of London, Thomas Keith, of Edinburg and Lawson 
Tait, of Birmingham, have been echoed and re-echoed 
from continent to continent, all on account of adding 
thousands of years to woman's life. This same just praise 
is now being acknowledged everywhere to the proud name 
of Lister. 

While the practice of antiseptic surgery is saving 
thousands of years to man's life, it is also preserving to 
thousands of other men their limbs, which in joint of fact 
is next to life itself. 

May we not hope that the faithful use of antiseptics 
in obstetric practice will add yet many thousands more 
years to w^oman's life? 

Who among us is entirely satisfied with the results of 
his obstetric practice? Are there any of our number not 
desirous of seeing a better state of things surrounding 
their puerperal patients? It is not rather the exception 
than the rule, for a woman in child-bed to make an uncom- 
plicated recovery. 

I do not mean to say that many of our puerperal 
patients are seriously sick, but that many do develope 
symptoms within the first week which seriously attract 
the attention of the zealous practitioner. 

Conceding this to be true, the proposition that some- 
thing better is desired, becomes self-evident, and therefore 
requires no argument. 

Antisepticism of course means that which opposes 
putrefaction, and as putrefaction is caused by fermenta- 
tion, it follows that if we can prevent the access of the 
fermenting spore, or destroy it after it has gained entrance 



74 The Peoria Medical Monthly. 

to wounded and absorbing surfaces, we will then have 
been been successful in the application of the antiseptic. 

Antiseptic treatment also assumes a firm belief in 
specific germ poison. Just what this specific poison is, 
that gives rise to the febrile condition of our puerperal 
patients, we are unable to say, Neither can we say just 
what the infection is that produces scarlatina, small-pox or 
typhoid fever. Nevertheless we are all conscious that 
such poisons do exist. 

In ordinary practice we see all, or nearly all of our 
puerperal patients recover with but slight fever; and 
therefore with the feeling of security or confidence which 
upon our usual observance has given us, we may not 
upon first thought, be prepared to accept the theory of 
puerperal infection. 

But there comes a time, when erysipelas, scarlet fever 
or septicaemia may be prevailing to a greater or less extent, 
and then, unless very great care is exercised on our part, 
we may sadly see every woman upon whom we may have 
attended in child-birth, seized with a fearfully fatal form 
of puerperal fever. These serious forms of fever but too 
often arise in ordinary practice, without the apparent epi- 
demic influences just mentioned. 

So do isolated cases of diptheria and the eruptive 
fevers develop now and then in every locality without our 
being able to trace the source of infection. Under these 
circumstances we explain that it is most likely due to 
germs of the peculiar disease, which have in some natural 
manner been awakened from a dormant condition to a 
state of activity. 

Or perchance the infection may have been transpor- 
ted in food or clothing. With this state of things, the true 
physician, like the true christian when asked for an expla- 
nation of certain apparently inconsistent statements of 
scripture, replies that by means of that sublime faith which 
illuminates his understanding he comprehends easily that 
which the sceptic submits again and again to the most 
rigid process of analysis. 

Therefore gentlemen, with the memory ever fresh in 



Original Communications. 75 

our minds, of women dying of child-bed fever, and with the 
light dawning from this era of antiseptics in obstetric prac- 
tice, does it not behoove us to meet together and counsel 
one with the other as to the advisability of doing more for 
these mothers of our people? 

You will already have inferred from the foregoing 
remarks that the pathology of fever following child-birth 
adopted in this paper is that of septic infection. However 
that I may not appear doubtful, I will say "that I regard it 
as identical with surgical septicaemia or pyaemia, and that 
the variations which exist in the clinical history are simply 
those which are peculiar to the organs invaded." 

These are the views of the foremost medical writers of 
both Europe and America. A woman recently delivered 
is in an analogous condition to a person who has under- 
gone a surgical operation, or sustained an injury with a 
breach of continuity. The entire genital tract is to a 
great or less extent in a condition of traumatism. 

Now these various foci, placental, cervical, vaginal and 
perineal are peculiarly liable to be affected by any poison- 
ous gernis that may present themselves. 

There are two ways by which these poisons may gain 
entrance to these vulnerable points. First through the 
medium of the atmosphere; second, by the finger ot the 
doctor or nurse, by instruments and by clothing. 

We may now inquire how we can best protect our 
patients from all possible sources of infection. If we ad- 
mit the liability of disease in this manner, we cannot ex- 
cuse the neglect of precaution on the grounds, that the de- 
tails are too troublesome to enforce. No physician should 
take a case unless he can give to it the ordinary skill and 
attention of his profession. 

Otherwise he is justly liable to prosecution for damage. 

I make it an invariable rule before examining a wo- 
man in labor to wash my hands in hot water, using soap, 
scrubbing fingers and nails thoroughly with nail brush, 
then prepare an antiseptic solution of either carbolic acid, 
one to forty, or bichloride of mercury, one to one thousand, 
immerse my hands in this for a few minutes, and then pro- 



76 The Peoria Medical Monthly. 

ceed with the examination ; and at its conclusion again 
wash my hands with soap and hot water. 

I avoid frequent examinations, and regard that practi- 
tioner as truly meddlesome who sits constantly by the 
bedside with one or more fingers in the vagina of his 
patient. Of course there are many women who have sub- 
mitted to this officiousness, and think it the proper func- 
tion of the doctor, and they will really complain of you 
unless you too will foUow' the example set by their doctor. 
I always tell them kindly that mj^ duty is to patiently al- 
low nature the supremacy, and in the rare event that she 
was incompetent, then I should interfere on behalf of both 
nature and my patient. I endeavor to learn all that can 
be learned at the first introduction of the finger, and after- 
wards judge of the progress of the labor by the general be- 
havior of the patient. 

The experienced obstetrician can tell by the character 
of the patient's outcrys and the involuntary expulsive 
pains when his services are likely to be required. How- 
ever, the hand should be immersed for a few moments in the 
antiseptic solution prior to each examination. 

When the head of the child has descended to the in- 
ferior strait, a napkin, w^iich has been dipped in warm dis- 
infectant and squeezed, should be laid over the vulva. 
This acts as a guard, and also affords the doctor useful aid 
in supporting the perineum. Other napkins may be treat- 
ed with the antiseptic solution, and without much wringing 
put upon the rack to dry, to be used finally as ordinary 
cloths to the external genitals. 

The antiseptic which at present is in greatest favor is 
corrosive sublimate. The proportions recommended are 
one to one thousand as being quite strong for any purpose, 
and one to two thousand for vaginal and uterine injections. 
The advantages of the sublimate solution are its stable 
qualities and powerful antiseptic properties. 

It is not volatile like carbolic acid and eucalyptus, nor 
poisonous to the same degree as iodoform. It is also en- 
tirely free from odor, a quality which makes carbolic acid 
and iodoform so objectionable. Unlike carbolic acid it is 



Original Communications. 77 

an absolute germicide, and gauze or other materials im- 
pregnated with it are rendered antiseptic for an indefinite 
period. Carbolic acid on the other hand is a doubtful dis- 
infectant in dilute solutions, and readily evaporates, leav- 
ing the vehicle almost entirely destitute. of antiseptic 
properties. 

The ease and readiness of extemporizing the sublimate 
solution is a matter which strikingly presents itself to the 
practitioner w^ho may be called upon away from his office 
to take charge of cases requiring the use of antiseptic 
treatment. 

About seven and a hall grains of the bichloride to a 
pint of water gives us the strength of one to one thousand. 
It occurred to me that the bichloride could be put in gela- 
tin capsules and thus get a most convenient means of 
transporting the drug. Therefore I had the smallest size 
capsules filled with the powdered sublimate, and found 
that each capsule of this size holds about seven grains. 
Two dozen of these filled capsules can be put in a two 
dram vial, care being taken to duly label the vial not only 
corrosive poison, but with the skull and cross-bones. This 
small vial, this imdhim in parvo, can be carried in one 
corner of the vest pocket ; and when we are called, either 
to a case of labor or to a surgical case, we have our little 
antiseptic, if not exactly in a nutshell, enclosed in a thin 
shell of gelatine, which dissolves very quickly in a pint of 
water. This solution is not so destructive to the cuticle of 
the doctor's hands as carbolic acid. We all know how car- 
bolic acid, one to twenty, or, for that matter, one to one 
hundred, cracks and scales the skin of the hands. Carbolic 
acid produces a veritable eczema of the hands of the sur- 
geon, and in addition to the discomfort, the cracks fill 
with dirt, w^hich no amount of washing will remove, pre- 
sent an unsightly appearance. Besides all the disadvant- 
ages of carbolic acid, the exceeding cheapness of corrosive 
sublimate is an important recommendation. 

I do not think it advisable in the absence of an epi- 
demic of puerperal fever, especially in the private practice, 
to administer this, or any solution by vaginal injection, as 



7S The Peoria Medical Monthly. . 

a preventative measure in a normal reaction from child- 
birth. But in the event of manual or instrumental man- 
ipulation within the cavity of the uterus, 1 think it best to 
wash out the womb at the completion of the labor with a 
hot solution of the bichloride one to two thousand, by 
means of either a fountain or Davidson's syringe. The in- 
trauterine injection should not again be given except symp- 
toms of severe illness appearing, such as high fever, ab- 
dominal pain or distension and offensive lochia; then the 
same strength solution should be given at a temperature 
of 100*^ Fh., by intrauterine injection, and continued at 
intervals of three to eight hours, according to the indica- 
tions as shown by the immediate fall in body temperature, 
cessation of pain and sweetness of the uterine secretions. 
After forty-eight hours perseverence in this method of 
treatment, if the patient's condition did not improve, it 
should be suspended, and reliance placed upon the usual 
means of treatment. 

These intrauterine injection are given through nozzles 
specially designed for the purpose, as Chamberlain's glass 
tube and Nott's double gum catheter. I prefer the latter; 
it is not always the simple and easy task to wash out the 
womb that it might appear to be so soon after parturition. 
We are not so liable to do harm with the gum catheter as 
with the other non-flexible instruments. The tube is in- 
troduced with the antiseptic solution flowing through it in 
order to avoid injecting air; two fingers are passed in the 
vagina and press upon the posterior lip of the womb, 
while the tube is passed along between the fingers and 
guided into the uterus. A bed pan is of course indispensi- 
ble. These intrauterine injections are seldom required, 
but where the hand, forceps or curette is passed into the 
uterus either for delivering the foetus or after child-birth, 
the hot bichloride solution should be administered as a 
prophylactic measure. 

Obstetric art has always insisted upon the greater dan- 
ger of those cases where it has ])een incumbent upon the 
practitioner to introduce his hand into the womb. This 
tear may be well founded, but it has deterred many a doctor 



Original Communications. 79 

from timely manual interference, and thus while trying to 
save his patient from an adventitious evil, he has allowed 
her to struggle on amid dangers real and destructive. While 
the imaginary fear of doing harm to the mother existed solely 
in the doctors mind — an heir loom of the time where anti- 
septic practice was unknown. It is a source of great grat- 
ification to the physician to know that after the severe 
cases of complicated labor, that the intrauterine antiseptic 
injections will probably convert the condition, of his case 
to that af simple natual labor. 

In the few cases where offensive lochia is the only note- 
worthy symptom, the injections should be confined to the 
vagina, and given two or three times a day. In cases of 
natural labor no injections are permitted. In all cases, as 
soon as the parturient act is completed, the patient's thighs, 
buttocks and vulva are thoroughly w.ashed in the warm 
bichloride solution, and all soiled body and bed clothing 
are replaced by warm and dry linen. The physician who 
will take the pains to examine his patient after labor will 
frequently find the hair upon the monsveneris and labia 
majora matted with tenacious blood clots. Where this is 
not washed away, is it any wonder that we should have 
stinking lochia if by good luck we should escape septic 
infection ? 

It is -scarcely necessary to insist that the womb should 
be entirely emptied of placenta, membranes and coagula. 
This can best be accomplished by Credo's method, that of 
expression. Credo's method consists in making light fric- 
tion movements over the hypogastrium until the womb is 
felt to contract, at which moment the physician instantly 
grasps the uterus with both hands, the fingers enclosing 
the fundus and posterior walls, the two thumbs the anter- 
ior surface. Pretty firm pressure is now made in the direc- 
tion of the superior strait, and at the same time the uterus 
is tightly squeezed. This expression is only permissable 
during a uterine contraction. And to insure good perma- 
nent contraction, that the womb may not be a hot-bed for 
decomposed blood clot, we should give moderate doses of 
ergot three times a day for a week. This not only prevents 



so The Peoria Medical Monthly. 

the severe after pains, which are the gall of bitterness to 
the lying-in patient, but conduces to speedy involution 
and consequently a good getting up. 

In every case the placenta should be carefully exam- 
ined to know whether it has all been removed; for it does 
occasionally happen that a greater or less part of it has 
remained, involving the patient's life in considerable dan- 
ger, or at any rate causing very annoying haemorrhage. 

Xext in order and importance, after removing the 
after-birth, is to uncover the patient, and by aid of a good 
light carefully examine the perineum for rupture. This 
accident occurs more frequently than any of us know; and 
I feel strongly the conviction that it is our duty to close it 
at once, except where it may have been complete, involv- 
ing the sphincter ani muscle and rectum. 

If the perineum is torn and we decide to do the imme- 
diate operation, we should stuff the vagina, high up with 
antiseptic sponge, cotton or rags, to temporarily arrest the 
uterine bleeding. Compresses dipped in the hot solution 
of corrosive sublimate one to one thousand, should be 
pressed against the bleeding wound in the perineum until 
all haemorrhage ceases. One, two or three sutures of either 
wire or antiseptic silk will be sufficient to repair the lacer- 
ation. Care being taken in passing the sutures to have 
them deep, or out of sight from point of entrance to that 
of exit. These sutures should be twisted or tied moderately 
close and removed at the end of a week. An anaesthetic is 
not always required in the immediate operation. How- 
ever, if the patient is not already smartly under the influ- 
ence of ether or chloroform given as a matter of mercy or 
humanity in mitigating the pains of the second stage of 
labor, the severity of which pains language i« inadequate 
to describe, then I think it advisable, if the patient desires 
it, to use an anaesthetic for passing the sutures. A suitable 
needle for this operation should always be carried in the 
pocket case. Of course the temporary tampon introduced 
at the beginning should be removed at the close of the oper- 
ation. The dry antiseptic napkins already mentioned 
should now be used exactly as the ordinary napkins are 
used after labor. 



Original Communications. 81 

Art. III.— Anthrax — Read before the Pawnee Covnty (Neb.) Medical Society, 
by W. .0 Henry, M. D. 

Allow me to call your attention to a disease though 
comparatively rare yet well known and of rather serious 
nature, which in our standard works is not as clearly dis- 
cussed as might be desired ; and in the treatment of which 
there is not that harmony among surgeons which we have 
a right to expect when a disease is thoroughly understood. 
I refer to that painful and often fatal dise'ase, Anthrax. 
What is it '? What is the most rational treatment, and 
why ? Before attempting to answer either of these ques- 
tions I will cite in your hearing a case in point. Feb. 15^ 
1884, Mr. S. called at my office and requested me to exam- 
ine a small pimple upon the back of his neck, which, though 
not large, was painful and caused him to fear the approach 
of something serious. As he had been troubled with nu- 
merous boils, and the pimple was so insignificant in ap- 
pearance, I told him not to be at all uneasy as it would 
doubtless prove to be a boil. A few days later he again 
called my attention to his boil and complained of consid- 
erable pain. I directed the local application of equal parts 
of tr. aconite and tr. iodine, for only a short time before 
I had successfully used this preparation in abroting a palm- 
ar abcess for him. This treatment was followed lor sev- 
eral days, but to no good purpose. Examinations now 
showed a flattened circumscribed swelling of a dusky red 
hue, very tender and about three inches in diameter. I 
ordered a flax seed poultice constantly applied, gave iodide 
of potassium and syr. of sarsparilla co. three times a day. 
A good cathartic was given and the patient left with his 
nurse, who wa,s required to pay close attention to the poul- 
tices night and day. In case of sleeplessness hyd. of chloral 
was ordered to be used. A few days later I saw him again 
and found the poultices had done good service, for although 
there was still that flattened crown to the tumor, yet it 
could now be inclosed within a circle tivo inches in diame- 
ter. The poultices and other treatment were continued 
and a few days later six openings appeared around the 
crown of the swelling, each discharging more or less, and 



k 



i82 The Peoria Medical Monthly. 

through the openings could be seen the grayish sloughs. 
The poultices were continued until sloughs were removed 
when a simple dressing was used and the patient made a 
"Satisfactory recovery. During the entire course of the dis- 
ease the diet was of the most nutritious kind. This was 
evidently a typical case of Anthrax in a mild form, a simple 
treatment being all sufficient. We now return to our first 
question, What is Anthrax ? It is a group of boils in tissue 
of low vitality, arising in the course of general debility and 
giving rise to extensive sloughing. It differs from abscess 
in having these sloughs and no limiting or pyogenic mem- 
brane. Just here allow me to raise the question, Why does 
a boil have a core and an abscess none ? In abscess sup- 
puration begins in the centre of inflammation from a dead 
particle of matter, or other foreign body, and spreads to- 
ward the circumference, breaking down the intravening 
tissue, thus forming a cavity containing pus and disinte- 
grated tissue. In furuncle, inflammation continues until a 
central mass of tissue is strangulated, in consequence of the 
congestion and extravasation, which nature gets rid of by 
the formation of pus and breaking down of tissue until it is 
finally extruded. Now applying these facts to carbuncle 
we find from congestion of and exudation into tissue of low 
vitality a number of strangulated centres, around which pus 
is formed for whose exit an opening is formed over each 
slough. While around each core pus is being formed, the 
intervening tissues are either breaking down or forming 
new sloughs, the former being the more desirable result. 
Let us now in answering the next question keep in mind 
the foregoing facts and the treatment to be suggested will, 
it seems to me, be accepted as rational. I cannot see the 
utility of crucial incisions, for they do not open freely all 
of the pus centers, they do not remove any of the sloughs, 
but they do open new abscesses for the absorption of septic 
matter which may lead to disastrous results. Nor do I see 
how subcutaneous transverse incisions can do anything 
more than relieve some pain and assist very slightly in 
accelerating the discharge of sloughs ; and while potassa 
fusa will fulfil the indications perhaps better than either of 



Original Communications. 83 

the preceding methods, yet it is too slow iii its operation 
and altogether too painful. It is from the great pain, ex- 
cessive and protracted drain upon the system producing 
exhaustion, the extensive absorbent surface exposed to a 
poisonous secretion making pyaemia possible, that we are 
to guard our patient. These methods" all being ineffectual, 
as show^n, I propose something more radical, and if the 
pathalogy be correct, more rational. 

Apply a flax seed poultice constantly, change as often 
as necessary to get the full benefit of such poultice, until 
the disease has located itself within well defined limits, 
then dissect out or remove the entire diseased mass by 
enucleation and leave a healthy sore to granulate and fill 
up from the bottom. There is here no foul or poisonous 
discharge, there is now no danger of pyaemia and the pa- 
tient instead of gradually failing for weeks, at once begins 
to recuperate. We have done just what nature in time 
would do if the patient were to survive long enough. The 
patient has not passed through nearly so much pain, the 
system is not exhausted by a protracted and filthy dis- 
charge but is ready to embark on the highway to recovery. 
Let the internal treatment be supporting, the secretives 
kept as nearly right as possible and this with the local 
treatment suggested will enable many cases to recover 
which otherwise could not endure the more protracted 
course under the other plans of treatment. 

I have now fully answered both questions at the be- 
ginning of this article, and with what success, your friendly 
criticisms will determine. 



(Qnv CflJlittiat ^mtt^. 



[For this department we hope to enlist the co-operation of our friends. Short reports of 
interesting cases are especially requested from every one. We would like to have twenty or 
more such articles for each number. See editorial in No. 1, Vol. V, May, 1884.] 

Art. IV. — Ovariotomy; Operation Followed by Acute Rheumatism. By J, 

L. Hamilton, M. D., Peoria, 111. 

I do not know that there is anything of much interest 
to the profession, in this case ot ovariotomy that I have to 
report, except the almost entire absence of constitutional 



84 The Peoria Medical Monthly. 

disturbance from the operation, and the appearance, so- 
soon after the removal of the tumor, of inflammatory 
rheumatism. 

Mrs. 0., of this city, age 29 years, mother of one child, 
ten years of age, came into the Cottage Hospital April 
16th, 1SS4, to have a tumor of the ovary removed. I wa& 
first requested to examine this case about eight years ago— 
she was then quite fleshy, and when operated upon weigh- 
ing over two hundred pounds. At the time I first examined 
her I thought the tumor was connected with the uterus, as- 
that organ was large, the sound indicating a uterine depth 
of three and a half inches. Her health being good, at that 
time, there being no disturbance from the presence of the 
tumor. I advised her to wait developments, as I did not 
think she required treatment, and I did not think 
medicine would do her any good. She left me and sought 
other advice. She took a good deal of medicine for the 
next two years, without benefit. I was again consulted. 
The tumor had been growing all this time, but very slowly., 
She was still in quite good health, and there seemed to be 
no reason for surgical interference. About one year ago it 
began to give her considerable trouble, more from its 
pressure on other organs than anything else, and she was 
quite anxious to have it removed, yet her general appear- 
ance was that of good health. On examination now, I be- 
lieve it to be an ovarian tumor. In September last I 
aspirated the tumor and drew off about three gallons of a 
dark, coffee-colored fluid, a specimen of which became al- 
most solid by the addition of a small quantity of nitric 
acid. On examination of the tumor a few days after tap- 
ping I was convinced that it might be removed. Advised 
her to wait until the sack again filled up, and then I would 
operate. Mrs. 0., having received such preliminary treat- 
ment as I thought necessary previous to her entering the 
hospital. On the 17th of April, assisted by Drs. Mcllvaine, 
Boal, Will, Steele and others, I removed a dermoid tumor 
weighing twenty-five pounds. The omentum was quite 
firmly attached to the front portion of the tumor, which 
had to be peeled off and some small vessels ligated. The. 



Our Clinical Society. 85 

contents of the large cyst was drawn off, which contained 
a dark, grumous-looking liquid, which we were very care- 
ful to prevent entering the peritoneal cavity. The tumor 
was then lifted out and pedicle securely tied with a silk 
ligature. After separating it from the tumor it was re- 
turned into the cavity. 

The abdominal cavity was then thoroughly sponged 
out, the omentum placed in its natural position. It had 
been kept in warm towels until all seepage had ceased. 
The wound was now stitched up and the usual dressing ap- 
plyed. 

During the time she was being etherized she vomited 
once. After the effects of the ether passed off she com- 
plained of no sickness or unpleasant feelings. Her pulse 
remained at 76 during the rest of the day and evening. 
The morning of the 18th the pulse was 100 and tempera- 
ture 100 ; during the day the pulse rose to 112, tempera- 
ture lOOf . On the 19th pulse 96, temperature 99f ; by the 
fourth day after operation the pulse was down to 80 and 
temperature natural. 

I gave her nothing but a hyperdermic injection of mor- 
phina, ^ gr. every night. She hardly needed this, but after 
giving it one night she wanted it; said it made her rest so 
nicely. She continued to do well until the ninth day. 
The stitches had been removed and the wound entirely heal- 
ed, when she began to complain of pains in her knees and 
ankles. After remaining for a day or two on one side the 
other knee and ankle were affected, then the elbows and 
wrists, and even the finger joints were attacked, in short 
it took the usual course of a mild form of inflammatory 
rheumatism until nearly all the joints in the lower and up- 
per extremities were more or less effected. She did not 
have very high fever with it. This was the first attack 
of rheumatism she had ever had. It yielded readily to the 
use of salicylate of soda, fl. ext. colchicum and cimicifuga, 
quinine and iron — of course using the remedies as they 
were needed during the course of the disease. She was 
well enough to leave the hospital the 21st of May, just 
five weeks from the day she entered it ; feeling, indeed, 



86 The Peoria Medical Monthly. 

very happy to be relieved from a burden that had been so 
many years troubling her. 

On examining the tumor after its removal I found the 
parent sack entire ; not very large, but with a very firm 
wall. The sack, when opened, was found to contain a 
a white, cheesey-like substance, filled with hair. There 
were other smaller sacks. Some of these contained a clear 
liquid, but all seemed to have a diff'erent appearing fluid. 
No bones or teeth were found, but the sack from which all 
the other sacks seemed to have their origin being filled 
with a substance peculiar to the dermoid tumors and con- 
taining hair, this was certainly a tumor of that class. 



Art. v.— Report of last of Uncertain Diagnosis. By C. Baklow, M. D., Eaton, 111. 

Mrs. J. M. Age 42. Multipara. Family history good 
except her mother had temporary insanity about the time 
of the menopause. Five years ago I was called to see this 
lady and found her recovering from a severe convulsion. 
She was pregnant and in her seventh month. She had no 
more convulsions after my arrival, but was delivered of a 
dead foetus some three or four days later. She had a good 
getting up and enjoyed good health until about one year 
and a half ago ; she had an attack of erythema tubercula- 
tum which lasted some two or three weeks, since which 
time her health has been good until about nine months ago 
she noticed some swelling of her feet and also her face, es- 
pecially below the eyes. General anasarca soon made its 
appearance. I was sent for and found her very nervous 
and much excited. I examined the urine for albumin, but 
found none. The anasarca gave way in a few weeks, except 
in the feet, and her general health much improved. 

On the eighth day of last November I was called to see 
her again. She was recovering from a severe convulsion^ 
which was almost immediately followed by another. These 
convulsions were epileptiform and not hysterical. There 
was no all)umin in the urine. She passed about the normal 
quantity of urine, but it did not contain the normal amount 
of urea. I examined the urine from time to time during 



Our Clinical Society. ^ 87^ 

the next few months and could not find even a trace of al- 
bumin; neither did it contain tube casts. She had no more 
convulsions, but had persistent headache, some diarrhoea, 
suppression of the menses and marked mental aberration. 
She imagined that there were myriads of insects crawling 
over her and biting her. After a time the insects disap- 
peared and were replaced by small animals, such as mice 
and rats, which kept her picking and jumping about con- 
stantly. These were followed by serpents, which were still 
more annoying to her : and these by human forms, which 
were constantly in her room. They were not disagreeable 
to her but were rather pleasant and some of them were 
very agreeable. She was troubled with these apparitions 
some six or eight weeks, during which time she was more 
or less insane. Sometimes her mind seemed to be good. 
Soon after the apparitions in the form of human beings made 
their appearance she was entertained by unusual sounds, 
which she described as being made of wind instruments. 
The sounds she said were melodious and it was a pleasure 
for her to listen to them. Soon after this the apparitions 
disappeared, her mind cleared up, the anasarca gradually- 
subsided and her condition in every respect improved very 
much. She menstruates regularly. She is under treat- 
ment yet, but there are no signs of disease except some swell- 
ing of the feet when she stands up for a long time. 

Now what was the matter with this patient ? Could 
it have been Bright's disease ? There was no evidence of 
Bright's disease in the urine, but such evidence does not 
always exist. I do not believe it could have been general 
debility, as her health had been good. She was not poor, 
and certainly not very anseraic. Could it have been renal 
inadequacy, or could the near approach of the menopause 
have given rise to all these symptoms ? Answers to the 
above inquiries will be very much appreciated by the writer. 



Akt. VI. — Vomiting of Pregnancy. By J. S.Wallace, M. D, Hollenberg, 
Kansas. 

I notice a report by Dr. E. N. Campbell, of a case of 
obstinate vomiting in pregnancy, lelieved by pop corn. I 
had a similar case (interesting to me), but perhaps it might 



88 The Peoria Medical Monthly. . 

be an e very-day occurance to some of the older members 
of the profession. The following is the case as near as I 
can draw it from my note book: 

Mrs. J , 19 years old. had been married eight months, 

was called to see her Sept. 22, 1S83, found her suffering 
from nausea and vomiting every half hour; bilious looking 
matter, with considerable pure bile. Tongue heavily coat- 
ed and bowels constipated, temperature 102 ^ , pulse 120. 
Ordered a cathartic, which was at once rejected by stomach, 
repeated with the same result as before. For the next six 
days I gave patient everything almost the Materia Medica 
recommends for the vomiting of pregnancy, to no purpose, 
the patient rejecting everything. (I failed to state in prop- 
er place, she was about one month or six weeks pregnant.) 
About this time things looked serious, and like one grasp- 
ing at the last straw, I concluded to try popcorn. I direct- 
ed it to be well popped and ground and directed patient to 
Gat as much as she could during the night. On making 
my visit in the morning I found her resting better. She 
had vomited the corn three times during the night. I gave 
her by the mouth this morning — hydr. chlor. mit. 10 grs.; 
plumbi acetate. 2 grs., to be repeated in an hour, and with 
rectal injections succeeded in getting free action of bowels, 
after which patient gradually recovered. 

November 8, I was called again, and found my patient 
vomiting every few minutes. Everything that I gave her 
only acted as an irritant to the stomach, and from this date 
on she vomited persistently for ten days, at which time it 
gradually left her under the following treatment: 

IJ Acid liydrocyanic dil. % drachm. 
Aq. menth. pip. 1 ounce. 

M. Sig. : Teaspoonful every hour. 

This time the popcorn failed entirely, if it done any 
good in the first place. 



Art. VII.— Superfo'tation With Twin Delivery. By F. C. Gay, M. D., Alto 
Pa.ss, III. 

In support of " Our Clinical Society " I will offer our 
little mite, whether it proves or establishes anything. I 
report it mainly on account of its rare occurence, and if 



Book Notices. 89 

you de'em it of sufficient importance you can report it. 

I was called on the night of the 19th inst. to attend 
a Mrs. S. in confinement ; distance about 7 miles ; when I 
arrived she had been delivered about one hour and a half 
of twin girls. The lady in attendance remarked that she 
wanted me to examine the after-birth, that something 
came with it that she did not understand. On inspection 
I found a third child, the body and limbs presenting the 
appearance of a child in about the sixth month of gesta- 
tion. The head was a flat, shapeless mass, presenting no 
appearance of a human head. It was still in the unrup- 
tured membranes and was slightly putrefied. The two liv- 
ing children weighed about 6 pounds each. Appearance, 
healthy. The mother has so far made a good recovery. 



A Treatise on Ophthalmology for the General Practitioner. By Adolf Alt 
M. D. Illustrated; 8vo.; Cloth; pp. 244. J. H. Chambers & Co , St. Louis' 
1884. 

As stated by the author this work is not intended for 
the specialist, neither does it aim at making an oculist out 
of every genera,l practitioner, but to give him plain in- 
struction in so much of ophthalmological practice as he 
might reasonably be justified in attempting. We find the 
book just what it pretends to be, and sufficiently plain in 
most parts to give the instruction that the general practi- 
tioner needs. We believe it will fulfil the object for which 
it was written, and will prove a helper to all who have to 
treat the eye in general practice. The illustrations are 
numerous and for the most part well drawn. Paper and 
press work excellent. 

Hooper's Physicians' Vade Meciini. A Manual of the Principles and Practice 
of Physic, with an outline of general Pathology, Therapeutics and Hygiene. 
Tenth Edition. Revised by W. A. Guy, M. B., F. R. S., etc., and John Har- 
ley, M. D., F. L. S.. etc. Vol. I.; 8vo.; Cloth; pp. 338. Wm. Wood & Co., 
New York. 1884. 

The appreciation on the part of the profession of a 
work of this kind is shown, not only by the necessities for 
many editions of this work, originally published in 1823, 



90 The Peoria Medical Monthly. 

but also the success of similar works with which Harts- 
horn's essentials may be classed. 

This work, however, is much more elaborate and com- 
plete than the one alluded to, and may be justly called, a 
work on practice boiled down to practical use. It is a 
most useful book, especially for the young practitioner. 

Practical Manual of Obstetrics. By Dr. E. Verrier. Lecturer on Obstetrics 
in the Faculty of Medicine ot Paris. Fourth Edition. Enlarged and Re- 
vised. First American Edition, with revision and annotations. By Edward 
S. Partridge. M. D., Prof., etc. 8vo.; Cloth; pp. 384. Wm. Wood & Co., 
New York. 1884. 

Works on obstetrics during the past few years have been 
rather frequent, but we believe there is room for this latest 
one. The French have always enjoyed a great reputation 
as obstetricians and Prof. Verrier will cast no blot upon it. 
In fact, in reading his book we are impressed with the idea 
that he must have a good deal of Yankee common sense 
in his make up, for in the most instances he is plain and 
very practical. . Antiseptics find but infrequent mention ; 
and in his armamentarium tor the lying-in-room we find 
no mention of carbolic, corrosive or other now fashionable 
antiseptic. He believes in cleanliness and leaving much 
to nature. vSome of the instruments figured will be re- 
garded as curiosities. 

The American editor has done his work in a very sat- 
isfactory manner, his annotations being brief and to the 
point. The work is a valuable addition to the Medical 
Library. 



^mtt^ Uvn\mtim$. 



The Illinois State Medical Society. 

The thirty-fourth annual meeting of this society was 
held in the Methodist Church Block, Chicago, 111., begin- 
ing May 20th, 1884, and continued three days. 

The meeting was opened with prayer by the Rev. A. 
E. Kittridge, after which the address of welcome was 
made by Dr. E. Ingals, and responded to by Dr. S. K. Craw- 
ford, of Monmouth, on bahalf of the society. 



Society Transactions. 91 

The chairman of the committee of arrangements, Dr. 
D. W. Graham, then reported on the programme, members 
by invitation, various announcements, etc., after which the 
president, Dr. E. Andrews, of Chicago, delivered a brief, 
but pointed inaugural address, relating chiefly to the code 
of ethics. He would not advise any great change in the 
code ; it has stood the test and should be upheld. He drew 
a distinction between ethics and etiquette, and sustained 
the idea that gentlemanly conduct was the only principle 
really covered by the code. 

All preliminaries being finished, the first paper on the 
programme was called for, it being the report of the com- 
mittee on Practice of Medicine, through its chairman. Dr. 
J. C. Frye. of Peoria. Dr. Frye was present, but being un- 
able to read his report, it was read by Dr. T. M. Mcllvaine, 
of Peoria. The report was quite lengthy and covered the 
progress made in the treatment of a variety of diseases. 
The germ theory was discussed at some length, and in the 
main adopted by the reporter. 

The hour for adjournment having arrived before the 
close of the paper, its reading was suspended and the re- 
port referred without discussion. 

On assembling in the afternoon. Dr. D. Prince, of Jack- 
sonville, read a report of an operation for cleft palate, and 
exhibited the patient fully cured of his deformity. 

Dr. Roswell Park, chairman of the committee on 
surgery, then read his paper. He alluded to the recent 
surgical literature and reviewed the advances made during 
the past year. 

Dr. D. S. Booth, of Sparta, from the same committee, 
read a paper on gun shot wounds and sponge grafting. 

Dr. H. Gradle, of Chicago, read a paper supplemental 
to the report on practice. 

Dr. J. H. Robinson, of Chicago, read a paper from the 
committee on drugs and medicines ; read a paper on Alka- 
loidal and Kindred Medication. 

As the hall could not be obtained for an evening session 
the society adjourned uutil 9:30 a, m. Wednesday. 



92 The Peoria Medical Monthly. 

second day. 

After the nsual preliminary business, Dr. E. Ingals re- 
ported from the committee on Necrology. 

Dr. C. Fenger, of Chicago, read parts of a paper on 
Excision of the Hip and Knee Joints, exhibiting a number 
of patients on whom these operations had been made. 

Dr. M. P. Bassett, of Quincy, read a paper on vaccina- 
tion, advocating the use of pure humanized virus as prefer- 
able to the ordinary bovine virus used. This paper pro- 
voked quite a lively discussion, both pro and con partici- 
pated in by Drs. Ingals, Chicago; Strong, Chicago; Cor- 
coran, Brimfield ; Johnson, Chicago ; Jones, Danville ; 
Jones, Chicago, and the president. 

In the afternoon Dr. H. A. Johnson, of Chicago, read 
a paper on Bilateral Paralysis of abductors ot the vocal 
cords, exhibiting a patient on whom tracheotomy had been 
performed on that account. 

Dr. D. W. Graham, of Chicago, read a paper on 
Tracheotomy and Goitre, exhibiting the patient. 

Dr. J. P. Mathews, of Carlinville, read a paper on Dis- 
eases of Children. 

Dr. J. F. Todd, of Chicago, read a report from the com- 
mittee on the work of collective investigation. 

Dr. A. Wetmore, of Waterloo, read a paper on Physi- 
ology. 

Dr. F. C. Schaefer, of Chicago, reported a case of frac- 
ture of the greater tuberosity of the humerus extending 
into the bicipital groove. 

THIRD DAY. 

The committee on medical legislation in regard to the 
commitment of the insane reported progress, and expect 
during the present year to secure the needed changes in 
out laws on that subject. 

Dr. A. B. Strong called attention to the inadequacy of 
the present anatomical law in our state, and asked that 
every physician assist in having the law so amended as to 
make it accomplish its purpose. Several spoke in favor 
of the change. 



Society Transactions. 93 

The report of the nominating committee was then 
read by the chairman, Dr. E. Ingals, which was as follows: 

Place of next meeting, Springfield. 

President, Dr. David S. Booth, Sparta ; First. Vice- 
President, Dr. S. C. Plummer, Rock Island ; Second Vice- 
President, Dr. W. T. Kirk, Atlanta ; Assistant Secretary, 
Dr. H. B. Buck, Springfield ; Members of Judicial Council, 
Dr. S. K. Crawford, Monmouth ; Dr. Geo. Wheeler Jones, 
Danville ; Dr. John Wright, Clinton ; Committee of Ar- 
rangements, Drs. B. M. GrifBths, Matthews, Ranch, Whit- 
ney and Buck, all of Springfield. 

STANDING COMMITTEES. 

On Practice — Dr. Norman Bridge, Chicago; Dr. C. H. 
Norred, Lincoln; Dr. J. R. Livingood, Rossville. 

Surgery— Dr. W. A. Byrd, Quincy; Dr. D. A. K. Steele, 
Chicago; Dr. Cass Chenowith, Decatur. 

Obstetrics— Dr. C. W. Earle, Chicago; Dr. T. D. Wash- 
burn, Hillsboro; Dr. Anna S. Adams, Peoria. 

Gynecology — Dr. David Prince, Jacksonville; Dr. Sarah 
Hackett Stephenson, Chicago; Dr. 0. B. Will, Peoria. 

Materia Medica and Therapeutics — Dr. Thomas M. Mc- 
Ilvaine, Peoria; Dr. J. 'F. Todd, Chicago; Dr. Catherine 
Miller, Lincoln. 

Opthalmology and Otology — Dr. W. T. Montgomery, 
Chicago; Dr. C. R. Park, Bloomington; Dr. Robert Tilley, 
Chicago. 

Necrology — Dr. E. Ingalls, Chicago; Dr. William Hill, 
Bloomington; M. F. Bassett, Quincy. 

SPECIAL COMMITTEES. 

Laryngology — Dr. E. F. Ingals, Chicago. 
Oral Surgery — Dr. J. S. Marshall, Chicago. 
Pediatrics — Mrs. Dr. A. F. Rooney, Quincy. 
Dermatology — Dr. W. J. Maynard, Chicago. 
Orthopedic Surgery — Dr. C. E. Webster, Chicago. 
Tetanus — Dr. C. Truesdale, Rock Island. 
Insanity — Dr. R. J. Patterson, Batavia. 
Alcohol as a Therapeutic Agent— Dr. M. F. Bassett, 
Quincy. 



$4 The Peoria Medical Monthly. 

Effects of Malaria in Puerperal Cases — Dr. H. Judd, 
Gralesburg. 

Physiology — Dr. A. Wetmore, Waterloo. 

Treatment of Epilepsy — Dr. D. R. Brower, Chicago. 

Analysis of a certain class of remedies concerning 
which physicians are not positive as to their therapeutic 
value, Dr. W. L. Ransom, Rockford. 

Biographical Committee — Dr. J. Hollister, chairman. 

On the influence of appreciable metereological and 
topographical conditions on the prevalence of acute dis- 
eases— Dr. N. S. Davis, Dr. J. H. Hollister and Dr. J. F. 
Todd, all of Chicago. 

Committee on Legislation — Dr. B. M. Griffith, Spring- 
field; Dr. Walter Hay, Chicago; Dr. A. B. Strong, Chicago; 
Dr. J. L. White, Bloomington; Dr. F. B. Haller, Vandalia; 
Dr. W. A. Haskell, Alton; Dr. E. P. Cook, Mendota, and the 
committee of last year is to be continued. 

The committee on malignant growths, with Dr. C. 
Fenger as chairman, was continued another year. 

Dr. W. L. Ransom, of Rockford, read a paper on the 
analysis of a certain class of remedies, concerning 
which physicians are not positive as to their therapeutic 
value. 

Dr. S. K. Crawford, of MoAmouth, reported from the 
committee on Obstetrics. 

Dr. A. R. Babcock reported a case of dextro-cardia in 
a child three years of age, not congenital, and exhibited 
the patient. 

In the afternoon Dr. Ellen IngersoU read a suplement- 
ary report from the committee on Obstetrics. 

Dr. R. Tilley, of Chicago, reported from the committee 
on Ophthalmology and Otology. 

The Treasurer's Report gave a balance from last year 
of $1,141.00. 

The following delegates were appointed to the Ameri- 
can Medical Association, at New Orleans: 

Drs. J. F. Todd, N. S. Davis, W. W. Jackard, Arthur 
Reynolds, S. H. Stevenson, Chicago; 0. B. Will, Peoria; L. 
S. McArthur, E. Willis Andrews, F. H. Johnson, W. T. Bel- 



Society Transactions. 95 

field, A. A. Burr, Charles Webster, Simon Strasser, F. C. 
Shaffer, L. H. Montgomery, W. R. Caruthers, D. M. Cham- 
berlain, Walter Hay, R. Tilley, Moses Grunn, J. H. Hollister, 
E. F. Engals, H. A. Johnson, Maria Mergler, Chicago; J. B. 
Mathews, Carlinsville; D. Haller, Vandalia; H. Judd, Gales- 
burg; M. F. Bassett, Quincy; S. K. Crawford, Monmouth; 
S. H. Lambert, Assumption; A. K. Van Horn, Jersey ville; 
T. D. Washburne, Hillsboro; M. Reece, Abington; 0. W. 
Moore, Lockport; C. C. Hunt, Dixon; C. Armstrong, Castle- 
ton; B. M. Griffith, Springfield; J. F. Keefer, Sterling; D. S. 
Clark and W. L. Ransom, Rocktord; H. B. Buck, Springfield; 
T. F. Worrell, Bloomington; George W. Jones, Danville; E. 
H. Oyler, Mt. Pulaski. 

To the Indiana Medical Society— R. W. Gillette, of 
Danville. 

To the Missouri Medical Society — M. Hall, of Chicago, 
and B. H. Harris, of Groveland. 

Ohio Society — L. H. Montgomery, of Chicago. 

Michigan Society — Dr. Andrews. 

Wisconsin Society^— Dr. G. W. Jones. 

Iowa Society — Dr. Walter Hay. 

The following volunteer papers were then read — Books 
that Injure Children's Sight, by Dr. F. C. Hotz, Chicago; 
Dr. C. E. Webster read a paper on Potts' Disease; Dr. C. 
W. Earle on Pancreatic Anemia; Dr. R. Tilley exhibited a 
new ether inhaler; Mastoid Abscess, by D. E. Holmes, Dr. 
H. Gradle on Purulent Inflammation of the middle ear. 

A resolution was then adopted authorizing a prize of 
$100 for the best original treatise on the treatment of 
diphtheria, and $100 for the best tabulated statement of 
any ten cures coming under the tabulator, the prize to be 
adjudicated by a committee of three. Resolutions of 
thanks to the press and physicians of Chicago were offered 
by Dr. M. F. Bassett, of Quincy. The meeting adjourned. 



Twenty-Second Annual Session of the Iowa State Medical 

Society. 

FIRST DAY. 

The Iowa State Medical Association met in an annual 
session at Des Moines, Wednesday, May 21. The president, 



96 The Peoria Medical Monthly. 

Dr. Robiusoii. called the meeting to order; Rev. Geo. C. 
Heniy opened the session with prayer. The committee 
on arrangements reported; the minutes of last session 
were read and adopted. 

Dr. R. McXutt, of Des Moines, moved the appointment 
of a committee of one member from each congressional 
district for the collection of statistics of all diseases 
which have occurred in the state during the year, together 
with a sketch of the topography and flora of the districts 
where they occurred. Dr. Harvey moved the appointment 
of a special committee of three to whom this and all other 
subject touching the constitution and by-laws shall be re- 
ferred. The chair appointed on the committee Doctors 
Hobby, Hill and Field. 

The president, Dr. Robinson, delivered his annual ad- 
dress, which was attentively listened to by the members, 
and frequently applauded. It was an eloquent effort, and 
highly commended by all present. Dr. S. B. Chase present- 
ed an able paper on " Pulmonary Apoplexy," with a report 
of the case. The secretary then "read the following tele- 
gram : 

'' Sedalia, Mo., May 21. — Missouri State Medical Society 
to Iowa State Medical Society— Gentlemen : ■ Yoke-fellows 
in a common field and a common cause. Signed by Secre- 
tary. 

The secretary sent the following answer: 

To Secretary of Missouri State Medical Association, 
Sedalia, Mo. — The Iowa State Medical Association is happy 
to return fraternal greetings. We shall be most happy to 
exchange delegates with your society hereafter," 

Dr. G. E. Crawford, of Cedar Rapids, on "Acute Cat- 
arrhal Pneumonia — A Primary Disease." Dr. J. H. Green, 
of Dulnique, read a paper on " Contusion of the Brain from 
contra-coup — A Contribution to Cerebral Localization." 
Dr. M. D. Middleton presented a paper on "Glucose." Dr. 
D. W. Smouse read a paper on " Locomotor Ataxia," pre- 
senting a case to the association. The following dispatch 
was received and read: 

Baton Rouge, La., May 20. — Dr. S. E. Robinson, Presi- 



Society Transactions. 97 

dent Iowa Medical Association: The Louisiana State 
Medical Society, in session at Baton Rouge, sends fraternal 
greeting and best wishes for the success and prosperity of 
of your society. J. P. Davidson, M. D., 

President. 

The following reply was sent: 

Des Moines, May 20.— J. P. Davidson, M. D., President 
Louisiana State Medical Association, Baton Rouge, Louis- 
iana:^ The Iowa State Medical Society reciprocates your 
kind greeting, and we trust our fraternal relations maybe- 
come more firmly united. S. E. Robinson, M. D., 

President. 
evening session. 

Dr. Leighton, of Ottumwa, explained a recently invent- 
ed microscope. Dr. R. J. Farquharson presented a report 
on " Hygiene and Sanitary Science." A paper giving the 
history of the Davenport Board of Health was read by Dr. 
A. W. Cantwell. Dr. McNutt, of Des Moines, read a paper 
on ''Ethnic Force," which was discussed at length and re- 
turned to the author, as not being a medical paper. 

SECOND DAY. 

Society called to order by the president. Dr. Von 
Mansfelde, permanent Secretary of the Nebraska State 
Medical Society, was introduced and addressed the associa- 
tion briefly. Dr. Carter, a delegate from that society, in- 
troduced a resolution providing for a permanent inter- 
change of delegates between the state conventions. The 
resolution was referred to a special committee. 

The committee on finance reported, showing a balance 
on hand of |1,3S5. Dr. E. S. Robertson spoke on "School 
Hygiene," and the members dicussed the subject; a com- 
mittee was appointed to present to the State Board of 
Health a series of resolutions in regard to school hygiene. 
Dr. Thrall, of Ottumwa, presented a paper on " Boards of 
Health and Contagious Diseases." which aroused a hearty 
debate. 

AFTERNOON SESSION. 

Dr. Liveter, aged 85 years, one of the charter mem- 
bers, made a brief address, reviewing the history of the 



98 The Peoria Medical Monthly. 

society, after which a nominating committee was appoint- 
ed. The following papers were then read : " Ferity philitis," 
by Dr. M. G. Sloan, oiE" Dexter. " Bichloride of Mercury in 
Surgery," by Dr. Hanawalt, of Des Moines,. " An Improved 
Jacket Brace for the Treatment of Spinal Curvature," by 
Dr. D. C. Brockman, of Marengo; "Stricture of the 
(Esophagus," by Dr. E. W. Clark, of Grinnell; "Nerve 
Stretching," by Dr. Ristine; "Leprosy," by Dr. E. J. Far- 
quharson. All these papers were discussed by the sqciety. 
The secretary then reported a large number of additional 
arrivals of new, permanent mermbers, and members by in- 
vitation. 

evening session. 

On motion the secretary was authorized to employ 
clerical help, and allowed fifty dollars a year for services. 
Dr. R. A. Fatchin read a paper on compound fracture of 
the humerus, and exhibited a new splint for its treat- 
ment. 

A resolution providing that the society may offer a 
prize for the best essay, embracing original thought and 
investigation; the prize to be awarded by the committee, 
restricted by rules and regulations. Also, that the sum of 
$200 be placed to the credit of the publication committee 
for that purpose. Dr. Fitch moved that competition be 
confined to the society, which was carried. 

Dr. Hulzy moved that prizes be given to meritorious 
essays only, and that all essays shall become the property 
of the society. With these changes the resolutions were 
adopted. 

The committee appointed to recommend some action 
in regard to foreign correspondence, reported in favor of 
the appointment of inter-state delegates to other societies, 
and suggested that Dr. Donald McRae, of Council Bluffs, 
would be acceptable to the Iowa Society. The committee 
on the president's address reported. The main point 
raised in the report was the recommendation of the com- 
mittee requiring that delegates to the State society shall 
only be admitted from living, working local, county or dis- 
trict associations. The report was adopted. 



Society Teansactions. 99 

The paper of Dr. McCleur was read by title and re- 
ferred. 

A paper on "Insanity of Women" was read by Dr. 
Jennie McCowan, of Davenport. 

THIRD DAY. 

Routine business was transacted, and Dr. Jennie Mc- 
Cowan's paper was discussed at length. Other papers were 
read, as follows: Dr. G. 0. Morgridge, "Obstructive 
Dysrnenorrho3a;" Dr. R. H. Stephenson, "ITteriue Thera- 
peutics;" " Report on Ophtalmology and Otology," by Drs. 
•Hazen and Cruttenden," " Treatment of Obstruction of the 
Lachrymal Canal," by Dr. F. E. Cruttenden; "Hypnotics," 
by Dr. Ira K. Gardner. 

AFTERNOON SESSION. 

The reports of various officers were received and 
adopted, and delegates appointed to the American Medical, 
the Nebraska and Wisconsin societies. 

The committee appointed to present resolutions in re- 
gard to school hygiene, made the following report: 

The undersigned, your committee to whom was re- 
ferred the subject of school hygiene, for the purpose of 
calling the attention of the State Board of Health to some 
of the more important defects in the present methods of 
educating children, often brought to our notice as physi- 
cians, respectfully submit the following report: 

Whereas, The attention of this society having been 
directed to the imperfections in the locations, construction 
and arrangements of school buildings; also to the manage- 
ment of pupils by parents and teachers, therefore. 

Resolved, 1. That ample play grounds, with proper 
shade and drainage, should be carefully considered by 
School Boards. 

Resolved, 2. That school houses should not be more 
than two stories in height, that the rooms should be sup- 
plied with abundant means for supplying fresh air and 
ventilation, so as to secure an equable temperature at 
about 70 degrees F. Furthermore, that the stairs should 



100 The Peoria Medical Monthly. 

be wide, but not steep, and the doors for egress should be- 
large enough and open outward. 

Besolved, 3. That desks should be so arranged that 
the light will be introduced on the left side if possible^ 
upon the right side or from behind, but never so as to- 
strike pupils squarely in the face. 

Besolred, 4. That we condemn the practice of send- 
ing children to school before they are seven years of age; 
also the tendency to the " cramming '' process which so 
often checks, rather than promotes physical^and mental 
development. Again we urge greater discretion on the 
part of parents about putting children into school in spe- 
cial cases, when the health is imperfect, or where the child 
is remarkably precocious. 

Besolved, 5. That this society request the State Board ^ 
of Health to take some action to bring this subject to the 
attention of the State Superintendent, the County Super- 
intendents and Boards of School Directors. 

Resolved, 6. That the Board of Health should also 
make known the facts collected and tabulated, regarding, 
the increase of diseases of the eye in school life; also im- 
part instruction in the methods by which this organ is re- 
lieved of the excessive strain which modern civilizatioiL 
makes upon it. 

Wm. Watson, G. K. Hill, 

H. A. Oilman, E. H. Hazen, 

George F. Jenkins, Committee. 

Dr. Robinson offered the following.resolution: 
Resolved, That the Legislature of the State of Iowa 
be requested to pass a law making it obligatory that the 
formulary of patent medicines and proprietary medicines, 
be printed on the inside label of the package or bottle, so 
that an antidote for such poisons may be had in time to 
save the patient. 

The resolution was adopted unanimously. 

election of officers. 

President— H. C. Huntsman, of Oskaloosa. 
First Vice-President— H. B. Ransom, of Vinton. 
Second Yice-Presiaent— C. C. Griffin, of Vinton. 



Society Transactions. 101 

Secretary— Dr. J. H. Kennedy, of Des Moines. 

Assistant Secretary — Gr. E. Crawford, of Cedar Rapids. 

Treasurer — Gr. R. Skinner, of Cedar Rapids. 

Place of meeting, Cedar Rapids, on the third Tues- 
day of May, 1885. 

Committee of Arrangements — H. Ristine, Cedar Rap- 
ids; C. H. Hobby, Iowa City; A. F. Reed, Cedar Rapids; 
W. E. Egan, Atlantic; G. R. Henry, Burlington. 

Committee on Publication — J. F. Kennedy, L, C. Swift, 
Des Moines; W. D. Middleton, Davenport; J. Williamson, 
Ottumwa; CI. R. Skinner, Cedar Rapids. 

Committee on Necrology, First District — J. A. Scroggs, 
Keokuk. 

Second — A. W. Cantwell, Davenport. 

Third— S. N. Pierce, Cedar Falls. 

Fourth— L. P. Fitch, Charles City. 

Fifth— W. C. Schulze, Marengo. 

Sixth— F. W. Clark, Grinnell. 

Seventh— W. H. Ward, Des Moines. 

Eighth — P. Llewellyn, Clarinda. 

Ninth — J. D. Holmes, Audubon. 

Tenth — A. D. Meredith, Ames. 

Eleventh — G. W. Briggs, Sioux City. 

Committee on Ethics — S. E. Robinson, West Union; J. 
D. McCleary, Indianola; A. W. McClure, Mt. Pleasant; P. 
8. Mosher, Boone; W. S. Robertson, Muscatine. 

Speeches were made by the retiring and newly elected 
presidents. After the usual complimentary resolutions, 
the society adjourned, the meeting having been the most 
successful in the history of the society. 



Twenty- Seventh Annual Session of the Missouri State Medical 
Association, May 20. 

President Dr. E. H. Gregory called the association to 
order. Prayer was offered by Rev. C. A. Foster. Hon. Geo. 
F. Logan delivered an address of welcome in behalf of 
the city, and Dr. J. W. Trader, president of the Pettis 
Oounty Medical Society, in behalf of the local physicians, 



102 The Peoria Medical Monthly. 

welcomed the association. An appropriate response was- 
made b}' President Gregory. 

The committee on credentials made a partial report, 
showing an enrollment of seventy-six members up to that . 
time. 

Dr. L. J. Matthews offered a resolution restricting the 
time for reading reports of standing committees to thirty 
minutes, and voluntary papers to twenty minutes. Dr. 
Thompson offered an amendment, which was adopted, that 
a synopsis be read and the paper referred to the publication 
committee. 

A letter of regret from Dr. Hurt, of St. Louis, explain- 
ing his absence, was read. The question, who shall be 
delegates to the association, was raised, and a resolution 
by Dr. Lutz, of St. Louis, amending the by-laws, so as to- 
keep out non-members of local or district societies, called 
out considerable discussion. 

Dr. Allen, of Liberty, spoke in favor of Dr. Lutz' reso- 
lution, saying, he regarded the resolution as encouraging 
local societies. Requiring members of the State associa- 
tion to be members of local or district societies, he thought, 
would tend toward making them enroll in their districts. 

A motion to have the matter laid over in charge of a 
committee of three for one year was lost. A motion to 
refer to- a special committee, to report at three o'clock, pre- 
vailed. Drs. Teft, Hanna and Trader were appointed on 
the committee. 

afternoon session. 

Dr. Ohmann-Dumesnil read a paper, reporting a case 
of "Universal Eczema," which was discussed by the mem- 
bers. 

Dr. G. M. Dewey, of Keytesville, read a paper on 
"Causes and Cure of Quackery," which was discussed by 
numerous members of the society. 

A resolution indorsing the course of the State Board 
of Health, was offered by Dr. CI. Y. LaBrurne, of St. Louis. 
The resolution called forth considerable discussion, some 
approving of the law as now enforced by the Hoard, and 
others dissenting. 



Society Tkansactions. 103 

Dr. Allen, of Liberty, said that there had been an ef- 
fort by the State Legislature to establish a State Board of 
Health, and that a law had been passed looking toward the 
suppression of quackery, and, notwithstanding this, there 
were disreputable practitioners all over the State, who 
practiced side by side with honest and qualified physicians. 
He was in favor of amending the present law as enforced 
by the State Board of Health, so as to make it more effect- 
ive. The resolution was, on motion, tabled. 

Dr. W. C. Glasgow reported. a case of remarkably slow 
pulse, which was discussed by the society. 

A resolution forwarded by Dr. Hurt, of St. Louis, to 
amend the by-laws, then came up for consideration. Dr. 
J. E. Teft, on the committee of by-laws, offered a substi- 
tute to Dr. Hurt's amendment, as follows: 

L — Honorary members shall consist of all those who 
have served as presidents of this association with such dis- 
tinguished members of the profession, not residents of the 
State, who shall be elected by three-fourths of the mem- 
bers present at a regular meeting of the association. 

H. — All members in good standing of regular medical 
societies in the State who shall be accredited by proper 
officers of said societies. The dues to be paid by all in at- 
tendance (other than honorary members) shall be $3.00; 
and such members shall be entitled to a copy of the trans- 
actions. Any physician in the state not a member, who 
shall remit $1.00 to the treasurer, on or before the annual 
meeting shall be entitled to a copy of the transactions. 

Adopted. 

EVENING SESSION. 

Dr. Teft read a committee report on "Medical Educa- 
tion." Dr. Potter read a paper on the "Relations Between 
Drinking, Insanity and Crime." Dr. Hart, of Brownsville, 
read a paper on the same subject; these papers were warmly 
discussed by the association. 

SECOND DAY. 

The second day showed a decided increase in attend- 
ance. 



104 The Peoria Medical Monthly. 

Dr. A. W. McAllister, of Columbia, offered the follow- 
ing resolutions, which were, after the defeat of a motion 
to table, passed: 

Besolred, That we recognize the ineflBciency of the 
present law regulating the practice of medicine, and the 
inabilitj^ of the Board of Health to accomplish the great 
good that was intended by this body when it recommended 
adoption by the Legislature. 

2d. That this society appoint a committee of at least 
five to visit our next Legislature and urge that honorable 
body to remedy at least the most glaring defects of the 
present law. 

3d. That this committee go uninstructed. 

4th. Thai each member pledge himself to carry out 
the objects of the above resolutions. 

A number ot letters and communications from mem- 
bers who were unable to attend the meetings were read. 

The president then delivered his annual address. 

On motion of Dr. Dickinson, the greetings of the as- 
sociation were tendered to the State Medical Associations 
of Illinois, Iowa and Kansas, now in session, and the secre- 
tary was instructed to transmit the same. 

Dr. Catlett, of St. Joseph, read a paper on " The Rela- 
tion of Insanity to the Practitioner." Dr. C. A. Todd, of 
St. Louis, read a paper on "Deafness following Mumps." 
Dr. A. J. Steele, of St. Louis, exhibited appliances for the 
treatment of hip-joint diseases. The report of the treas- 
urer was received and adopted. 

Dr. Geo. J. Engelmann made an appeal for contribu- 
tions to the Sims' memorial fund. Springfield, St. Joseph, 
St. Louis and Chillicothe were placed in nomination for the 
next place of meeting, and St. Joseph was selected. 

Dr. W. A. Hardaway read a paper on "Four Cases of 
Dift'used Sarcoma-cutis. Resolutions on the death of Prof. 
Gross were read and adopted. Dr. P. Y. Schenck, of St. 
Louis, read a paper on "Periodic Pain Caused by Diseases 
of the Womb, or its Appendages, not Relieved by Anti- 
periodics." 

state koard of health. 
J^r. Gore moved that those members of the State Board 



Society Transactions, 105 

of Health present be requested to make a statement of the 
work of the board since its creation. The members of the 
board present were, Drs. Gregory, Hearne and Hereford. 
The latter came forward and said the board was not 
ashamed of its work; in tact, it was proud of its conduct 
under one of the meanest laws ever passed by the Legisla- 
ture. Two thousand seven hundred and ninety persons 
had been licensed by the board to practice medicine in this 
State. Under the law we are bound to license persons 
who are of good standing, and comply with the letter of 
the law. We license many who should not be licensed, 
but we can't help it. When charges of misconduct, or of 
obtaining license under false pretenses, are made by the 
president or secretary of the local society, the board has 
the power to revoke such license. 

We have the power to quarantine against the trans- 
portation of small pox patients by the railroads, and have 
exercised that power in some cases. The powers of the 
board are now being tested in the courts of the State, and 
their decisions will guide our course in the future. We 
are going to do the work assigned us while we are in office, 
and request your support. 

Dr. Gregory then spoke in substance as follows : I 
am not a law maker, and sometimes think we could get 
along as well without as with them. Just when the Hlinois 
law was passed, such men of that State as thought their 
chances of securing a license there were very slim, picked 
up their traps and came to this state. We are now trying 
to rid our State of this class of men, and need the help 
and co-operation of the legitimate physicians of this State. 
When the discussion was had yesterday 1 felt so bad that 
T would have willingly withdrawn from the board. I beg 
you, now that I am there, to help us out in the work we 
have undertaken, and think much real good may be done 
' in placing our State beyond the pale of these quacks. I 
am assured that the board mean to do right in this matter 
— to the best of their ability. 

Dr. Britts then gave a short history of the law creat- 
ing the board. He was a member of the Legislature when 



106 The Peoria Medical Monthly. 

the bill was passed, and spoke as one knowing the true in- 
wardness of it. He said that when the bill was before the 
committee he and his colleague had fully made uj) their 
minds to vote against it, but were importuned by the com- 
mittee from this association to vote for it in order to get a 
law that could be amended on the statute books. 

Dr. Hearne, the secretary of the board, gave a detailed 
statement of the condition of his office. A large amount 
of abuse heaped upon the head of the secretary was due 
to other causes, and he was not in the least to blame for 
the delay in getting certificates, and loss of diplomas by 
the express companies and mail service. 

Dr. J. M. Pelot, of Brownsville, read a paper on 
" Variations from Types in Diseases." In the evening an 
elegant banquet was given to the association. Numerous 
toasts were responded to, and the occasion was a happy 
one in all respects. 

THIRD DAY. 

Dr. J. C. Mulhall, of St. Louis, read a paper on "Ther- 
mo-Cautery in Naso-Pharyngeal Diseases," after which fol- 
lowed the 

election of officers. 

for the ensuing year, with the following result: 

Dr. J. W. Middlekamp, of Warrenton, President. 

Vice-Presidents — First, Dr. E. F. Prewitt, of St. Louis. 

Second — Dr. W. E. Evans, of Brownsville.. 

Third— Dr. B. G. Dysart, of Paris. 

Fourth — Dr. H. M. Lane, of Smithville. 

Fifth— Dr. S. C. Griswold, of New Haven. 

Dr. Lutz, of St. Louis, Corresponding Secretary. 

J. H. Thompson. Jr., of Kansas City, First Recording 
Secretary, and N. M. Baskett, of Moberly, Assistant Re- 
cording Secretary. 

Dr. C. A. Thompson, of Jefferson City, re-elected - 
Treasurer. Adjourned. 



Pawnee County (Neb.) Medical Association. 

At the January meeting of the Pawnee County (Neb.) 
Medical association, the following members were present: 



Society Teansanctions. 107 

Drs. A. B. Anderson, E. Smith, W. 0. Henry, S. A. Wright, 
and J. W. Billiard. 

On motion, the name of Dr. J. E. Beemblossom, who 
was present, was added to the roll. 

A clinical case was presented by Dr. Smith: A boy, 
14 or 15 years of age, was affected with a cutaneous dis- 
ease. Dr. Anderson pronounced it a cas^ of eczema; had 
treated several similar cases with the local application of 
an unguent containing 30 to 60 grains of hydrargyrum 
ammoniatum to 1 ounce of vaseline, and following this 
with unguentum zinc oxide; giving internally Fowler's 
sol. arsenic, which had given good results. 

Dr. Wright corroborated the doctor's diagnosis, but 
used somewhat different treatment. Had received good 
results from local application of sol. of carbolic acid, tan- 
nic acid, and listerine; cleansing parts thoroughly with 
castile soap; kept bowels open, and in some cases gave 
tonics. 

Dr. Beemblossom concurred in diagnosis. Had used 
treatment similar to that used by Dr. Anderson, but had 
better results from local application of a solution of tinct- 
ure iodine, carbolic acid, etc. Gave quinine internally in 
some cases. 

Dr. Smith was of same opinion as Dr. Anderson, and 
used much the same treatment; had them cleanse the parts 
with green soap. 

Dr. Henry used milder unguent than Dr. Anderson; 
only 10 to 20 grains of white precipitate to 1 ounce of vas- 
eline. Was opposed to general use of carbolic acid as 
local application in such cases. 

Dr. Bui lard used much the same treatment as Dr. 
Wright. Gave in some cases comp. syr. sarsaparilla and 
iodide of potassium; where cuticle was removed, used 
locally an unguent of tannic acid, carbolic acid and vase- 
line. 

Dr. Wright read a paper on uremic convulsions, dwell- 
at some length on the different theories advanced regard- 
ing the etiology of puerperal eclampsia; was of the opin- 
ion that all cases of puerperal eclampsia were not called 



108 The Peoria Medical MonthLy. 

uremic poisoning. Would not bleed for relief of puerperal 
eclampsia, but depend on chloroform to control convul- 
sions, and chloral and bromide potassium for more perma- 
nent results. Would recommend free purgation and diu- 
resis. When precursory symptoms manifest themselves, 
the urine should be immediately examined for albumin. 

Dr. Anderson remarked that he had no criticisms to 
offer, and was very well pleased with the paper. 

Dr. Smith said it brought out the points he wished dis- 
cussed. 

Dr. Anderson then reported the case of a little girl, 
aged 11 years, who had endostitis of the fibula, for which 
he had operated. When the limb was first seen, it was 
red and swollen over lower extremity of fibula. He at that 
time informed the parents that he feared erysipelas, for 
which he prescribed cooling lotions. The inflammatory 
process kept extending up the limb, and finally began dis- 
charging pus from two openings. The consent of the par- 
ents was finally gained, and assisted by Dr. Henry, an op- 
peration was performed, which was repeated twice, remov- 
ing all the fibula except a small portion of the lower ex- 
tremity, which was apparently sound. The doctor had 
used listerine as a dressing in the case, and recommended 
it highly. The case had not fully recovered at this date, 
and it was not known what the permanent results will be, 
but at present is doing nicely. The family history is not 
good, they being of a decidedly strumous diathesis. 

Dr. Henry reported a case of chronic dyspepsia, which 
was successfully treated with elixir pepsin and tonics, 
which had to be continued several months. Began the 
treatment with hydrargyrum cum creta. Thought the 
lesson to be learned from this case was, that it required 
persevering treatment in such cases. 

Dr. Anderson regarded strychnia as the remedy in such 
cases. 

Dr. Smith read a paper on "The Identity of Croup and 
Diphtheria," taking the stand that the two diseases were 
identical; in which Drs. Beemblossom and Henry concur- 
red. Drs. Wright and Anderson took the opposite stand. 



Periscope and Abstract. 109 

On motion, Dr. Anderson was requested to prepare an 
article on the subject for our next meeting. 

Dr. Bullard then read a paper entitled, " The Duty of 
the Physician to his Patrons." He thought it the duty of 
the physician to disabuse the minds of the public of their 
superstitious ideas, also condemn the use of patent nos- 
trums. The physician should demand that such measures 
be carried out as he deems best for his patients welfare. 

Dr. Anderson thought that we would better look first 
to the bread and butter, and condemn their superstitious 
ideas only when we had their undivided confidence. 

It was moved and carried that the secretary be in- 
structed to have published in some medical journal the 
proceedings, in a condensed form, of our society, and that 
he correspond with the editor of The Peoria Medical 
Monthly, with a view to that end. 

Adjourned, to meet again in the office of Dr. Ander- 
son, on second Tuesday in April. 

J. W. Bullard, M. D., 
Secretary. 



CONDUCTED BY DR. 0. B. WILL, PEORIA, ILL. 
Cleansing- the Uterine Cavity after Abortion. 

On the above subject Dr. D. Inglis, of Detroit, has an 
article in the Journal of Obstetrics for April, from which 
we make the following extract, apropos to the question as 
to the advisability of thoroughly emptying the uterine 
cavity at once, after abortion: 

It not infrequently happens that when first called we 
find the cervix dilated sufficiently to easily admit the 
finger, and a portion of placenta projects more or less into 
the vagina. It is very natural to get hold of this, and to 
make traction either with the fingers or the placental for- 
ceps. Occasionally such a procedure brings away the en- 
tire placenta; but, unfortanately, the usual result is that 
some ragged shreds are torn off, and that which dilated the 
cervix is removed. The physician perhaps concludes to 
''give nature another chance," and, returning a few hours 



110 The Peoria Medical Monthly. 

later, finds the cervix shut up and the placenta locked in- 
side. If he gave a dose of ergot before leaving, such a re- 
sult can be looked for with considerable certainty. All 
that he has accomplished has been to close instead of open- 
ing the way. and he has possibly on his finger or on the 
forceps introduced septic germs, up to that time absent 
from the uterine cavity. 

Unless the placenta is to be taken away, it is simply 
folly to tear away the projecting portion. No! the time 
when is when we find the cervix open, and any delay is 
then a source of danger. And if dilatation does not occur 
spontaneously, or if the physician be called after the cer- 
vix has closed, after having already been dilated, artificial 
dilatation is and must be the first step to further action. 

Tents, dilators, or the finger may be used; much can 
be done with the finger alone. 

The instrument above all lor the removal of the 
placenta is the finger. In the hands of an expert the cur- 
ette is safe and generally efficient, yet even Dr. Munde, 
himself an expert advocate of the curette, reports a case 
where the fingers succeeded after the curette failed him. 
Further, 1 question seriously the ability of the general 
practitioner to so use the curette as to remove only the 
placenta. It is not, as Dr. Munde thinks, a question of an 
inexperienced hand perforating the uterus with the curette, 
for such an accident would mark something worse than in- 
experience. But greater or less wounds of the softened 
uterine substance could readily be made. 

By means of proper position of the patient so as to se- 
cure the utmost relaxation of the abdominal walls, and by 
external .pressure with the unemployed hand, the uterus 
can almost always be depressed so that the finger can reach 
the fundus. In cases of tense or thick abdominal walls, 
the administration of an anesthetic is an efficient adjunct 
and the depressing after effect of the pain is an additional 
argument in favor of its use. 

One case occuring in my own practice urges me here 
to give this warning: Avoid as far as possible crowding 
the uterus too hard against the sacrum. 

The case in point was one where no anesthetic was 
given. The abdominal walls were lax, yet the complete 
removal of the placenta was extremely difficult and tedi- 
ous. During the manipulations the sacral nerves were so 
seriously bruised that the patient suffered for several weeks 
from intense neuralgia of the sacral nerves and their 
branches. 



Periscope and Abstfact. Ill 

lu cases of extreme difficulty in reaching the fundus 
with the finger, more or less of the hand, and in multi- 
parae, the entire hand can be inserted into the vigina. 

The finger once in, care should be taken to get every 
possible portion of the placenta loosened, and 1 would here 
mention that the less often, in the course of the manipula- 
tions, the finger is withdrawn and reintroduced, the less 
the suffering of the patient. 

In case of the failure of the finger, the curette should 
undoubtedly be used, but with all care possible to avoid 
laceration of the uterine substance, and the same care to 
remove all portions of the placenta. 

Of the placental forceps I can only say that they do 
not seem suited to the removal of adherent portions ot 
placenta; and if they only succeed, as I believe they are 
apt to do, in tearing the placenta into shreds, they are of 
no actual use, and may do harm by misleading. As re- 
gards the thorough, complete and prompt removal of the 
placenta after child-birth, no question exists. 

So much then for the cleansing of the uterus of its 
grosser contents. It remains to consider the procedure to 
be followed when, after the delivery of the placenta at full 
time or after an abortion, there still remain substances in 
the uterus capable of putrefaction. In the case of removal 
of the placenta of abortion, as just outlined, it is not sel- 
dom that some detached shreds are left, or another physi- 
cian may have left some considerable fragments of placenta; 
or at full time the placenta may have been delivered and 
a portion of the membranes retained; or blood may be re- 
tained either from its forming clots too large to escape 
through the contracted os, or from a flexure of the uteras 
closing the exit. In all of these cases we have again the 
possibility of the formation of a centre of infection; and 
one principal object of this paper is to urge the more gen- 
eral use of the double intrauterine injection tube as a 
means of cleansing the uterine cavity. 



Plaster Splints for Fractures. 

In the Courier of Medicine for April Dr. W. M. Barrett, 
of California, gives the following as his method of apply- 
ing plaster of Paris dressing in recent fractures: 

For fracture of the tibia, or fibula, or both, I use a 
flannel splint in the shape of a stirup, the foot to be placed 
in the centre of it, and the splint to extend up either side 
of the leg to the knee-joint. This splint must be about 



112 The Peoria Medical Monthly. 

cue yard in length, three thicknesses of flannel, and wide 
enough to leave only a space of three-fourths of an inch 
in front and behind. After the measurements are taken, 
the splint is laid upon the floor, and dry plaster lightly 
sprinkled between the layers. Next, two bandages of 
coarse muslin, two an'd one-half inches wide and each eight 
j^ards in length, should be rolled, an assistant at the same 
time sprinkling and rubbing dry plaster into its meshes. 
These rolls should be placed in a basin of warm water a 
minute or so before applying them. While they are soak- 
ing the surgeon oils the limb, dips the flannel splint into 
warm water, squeezes it, places its centre on the heel and 
hollow of the foot, and brings it up smoothly on the sides 
of the leg. The bandages should now be applied, while 
traction is kept up and the ends of the bones are kept in 
apposition. 

While it is drying, the surgeon should polish the cast 
with a case-knife, which adds much to its beauty and pre- 
vents it from crumbling from contact with the bed-clothes. 
Care should be taken that it is neither tight nor loose at 
any one point, but that gentle and equal pressure is made 
at all points. Traction should be kept up for some minutes 
till the plaster is hardened. 

The limb should then be placed upon a pillow and 
slightly elevated. It should remain in this position for 
several days, if there is fracture of both bones. If there 
is only fracture of the fibula the patient may be up on 
crutches the next day. 



Feeding- Infants. 

The following points are gleaned from a clinical lec- 
ture on the above subject by Dr. John M. Keating, of Phil- 
adelphia, and published in the Archives of Pediatrics for 
April: 

The lecturer distinctly states that while dwelling at 
length upon feeding of infants with prepared food he does 
not wish to be understood as underrating the value of 
mothers' milk, or that of well-developed wet-nurse. First 
the mother, next wet-nurse, then prepared food. A child 
nursed for a short period can be much more easily brought 
up by hand. The kind of food upon which to place a child 
depends upon age, health, residence and circumstances of 
the family; is it to be weaned gradually or suddenly? The 
physician should form a regular course in his own mind 
and avoid the necessity for saying to mother "try this" 
or " try that." 



Periscope and Abstract. IIB 

Milk should form the basis of all preparations of food. 
Taking mothers' milk as a guide, Dr. Meigs has suggested 
the following formula: Order five or six packages of milk 
sugar, containing seventeen and three-quarter drachms 
each, the contents of one of these to be dissolved in a pint 
of water, and each time the child is to be fed let them be 
mixed together and then warmed, three tablespoonfuls of 
the sugar solution, two of lime water, two of cream and 
one of milk. A fresh mixture should be made for each 
feeding. The solution of sugar should be kept in a cool 
place and thrown away if it sours. The dry sugar keeps 
indefinitely, and is easily dissolved in warm water. A pint 
bottle should be kept to contain the solution and serve as 
measure. 

The milk should be good, ordinary cow's milk, and not 
that of high-bred stock, and cream such as usually sold in 
cities, containing sixteen or seventeen per cent, of fat. 
The quantity taken by new-born infants should be about 
two or three fl. ounces every two hours. 

In case where mother finds her milk gone, and i» 
obliged to hand-feed, if a course of tonics and exercise 
with a change of food will not return it, " order nurse or 
mother to take a quart of morning milk, pure and fresh — 
better from mixed dairy — and dilute with half a pint of 
water; put on to boil; take of Robinson's prepared barley, 
which comes in packages, a heaping dessertspoonful or 
tablespoonful; rub this to an even paste with a small 
quantity of milk; then add to it the milk that is boiling, 
and stir this for twentij to thirti/ miriutes, letting it boil. This 
should be strained, and a small quantity, say a teaspoonful, 
of white sugar added to it, the whole to be placed in the 
refrigerator for the day. When cool, a jelly will be form- 
ed. Of this the child should take about four ounces, made 
fluid by beating, and strained in bottle, or by spoon, every 
three or four hours. The last feeding would for a time be 
about ten o'clock in the evening; after a few months the 
child will need nothing after usual bed-time until first 
meal in the morning, at about seven o'clock." 

Should the bowels become constipated a preparation 
of oat meal, known as " Bethlehem oat meal," can be used 
instead of the barley. Sometimes it is well to mix these 
articles. A child under six months needs larger per cent- 
age of water. The lecturer is satisfied that infants are 
able to digest a small quantity of starchy food. The above 
preparation is applicable in a majority of cases, especially 
in indigestion during summer season. 



114 The Peoria Medical Monthly. 

Condensed milk is valuable, but should not attempt to 
raise a child on it. It is useful as a bridge to tide over 
difficulties. 

If a child is so weak and exhausted that it will not di- 
gest the mildest form of prepared foods, give some form of 
food requiring but little action of digestive juices. 

Great advantage is found in egg albumen, dissolved in 
■water, as food for sick children when stomach is intolerant 
ot ordinary milk food, also gum arable water will nourish 
and allay irritability. However, milk which has under- 

f^one partial digestion by pancreatic ferment, is most use- 
ul. The preparation must be made with care, as follows: 
" Into a clean quart bottle put a powder of five grains 
extractrum paucreatis and fifteen grains of bi-carbonate of 
soda and a gill of water; shake; then add a pint of fresh 
milk. Place the bottle in a pitcher of hot water, or set 
the bottle aside in a warm place for an hour or an hour 
and a half, to keep the milk warm; by this time the milk 
will become peptonised, when the contents of the bottle 
require a grayish yellow color and a slightly bitter taste, 
then the milk is thoroughly peptonised; that is to say that 
the caseine of the milk has been digested into peptone. 
Great heat or cold will destroy this digestive action, so as 
to prevent all further action; when you think that the di- 
gestion has progressed far enough, at once place the bottle 
of peptonised milk on ice, or into a vessel of boiling water 
long enough to scald its contents; it may then be kept like 
ordinary milk." The child will object to the milk if bit- 
ter. As soon as bitter is the least apparent, put on ice for 
cooling and use. Best results will be from extra care in 
preparation. 

Whejj is another admirable alternative in these cases. 
May be made with wine when great weakness exists. Milk 
should be alkaline; made so with bi-carbonate of soda. It 
is much better to use the spoon than bottle in feeding in- 
fants. Then the word colic will seldom be met in practice. 



Extra Uteriue Pregnancy. 

In the Pacific Medical and Surgical Journal for April 
Dr. Frank L. Adams reports a case of extra uterine preg- 
nancy, ending in the death of the patient from rupture at 
about the third month, the patient living but seventeen 
hours after the rupture. Post-mortem examination reveal- 
ed the fact that the ovum had not been grasped by the 
fimbriated extremity of the tube, but was separated from 
the abdominal cavity only by the amniotic sack. 



Periscope and Abstract. 11^ 

" The symptoms in the case were all the signs of in- 
ternal hemorrhage, viz.: Intense pallor, a weak pulse, 
which at times was hardly perceptible, an intense thirst 
which could not be allayed, coldness of the extremities, in- 
distinctness of vision, irritation of the rectum and tenes- 
mus. As proofs of an extra uterine pregnancy, local ten- 
derness in the right iliac and umbilical regions, the fact 
that the woman was in the third month of gestation, a 
most critical period in these abnormal pregnancies. The 
intense pain could have been produced by various causes, 
but in similar abnormalities it is a constant attendant. In 
addition, the knowledge that the woman had suffered more 
pain than common, and that the morning sickness had 
been unusually severe, while of little value, a prior i was of 
great assistance in making the diagnosis." 

The rupture took place at the junction of the amniotic 
sack with the placenta, leaving a large, free opening, which 
will readily explain the violent onset of the attack and the 
speedy termination of the case. 



strabismus Following Abscess of Lid. 

In the American Journal of Opthalmology for May Dr. 
I. C. Ayers describes a case in which strabismus followed 
an abscess in the upper eye-lid. There was marked swell- 
ing and oedema of the lid, and for a while the eye could not 
be opened. Poultices were applied, and in time the abscess 
was opened. The lid gradually resumed its normal ap- 
pearance, but the patient soon began to see double. An 
operation was done in the ordinary way and the results 
were immediate and satisfactory. 



Carbolic Acid— Paris Green— Belladonua— Poisoning-. 

In the Canada Lancet for June Dr. J. Mitchell details 
cases of poisoning by carbolic acid, Paris green and bella- 
donna, one of each respectively, with the exception of the 
last, of which there were three cases in the same family 
from drinking tea made by mistake from the fresh herb, 
and with the result of two deaths, notwithstanding the use 
of morphia and stimulants. Aid was too long delayed, and 
it was for a time uncertain as to the nature of the poison. 
In the case of the second, the patient died in five hours 
from the ingestion of the poison (half a teacupful of Paris 
green), mixed with water. 

Of the case of carbolic acid poisoning from swallow- 
ing a dessert-spoonful of pure acid the Doctor has the fol- 



116 The Peoria Medical Monthly. 

lowing to say: ''I was speedily summoned to attend, and 
was with the patient fifteen' minutes after she had taken 
the acid. I found her in a partial stupor, talking some- 
what deliriously, great muscular relaxation, weak, thready 
pulse, cold, clammy skm, pupils ot eyes slightly contract- 
ed, breathing becoming of a sterterous character. The 
invasion of the symptoms had been very rapid. Previous 
to my arrival the daughter had given an emetic of mustard 
without any effect. With some difficulty I aroused her 
sufficiently to drink four ounces of olive oil (all I had with 
me), when she recovered consciousness. I then prepared 
and administered an emetic of sulphate of zinc, which acted 
quickly and thoroughl}^, and soon left no doubt in our 
minds as to the nature of the poison, as the atmosphere of 
the room was impregnated with the odor of carbolic acid. 
After the emesis had ceased, we gave her demulcent 
drinks, applied heat to the body, and had the satisfaction 
of leaving her in a couple of hours in a fair way to recov- 
ery. The posterior and central portion of the tongue were 
hardened and corrugated by contact with the acid. The 
tongue and throat speedily healed; the stomach remained 
very irritable for a length of time." 



Appliance for Fractured Femur. 

In GaillarcVs MedicalJournal for May Dr. John Brown- 
rigg highly extolls the merits of a peculiar appliance which 
he has for some time employed in the treatment of frac- 
ture of the femur. In consists essentially of a broad band 
of two thicknesses of strong cotton cloth extending from 
just below the axilla to one inch and a half below the 
lower margin of the ribs, and passed around the body so 
as nearly to inclose it. This is fastened firmly by straps 
and buckle, and to its upper edge is sewed straps, passing 
over each shoulder and fastened to the posts on either side 
of the head of the bed. A broad band of cotton cloth is 
passed around the pelvis and attached to a post at the side 
of the bed, for the purpose of keeping the body aligned 
with the fractured limb. 

The ordinary adhesive plaster applied to the limb is 
used for counter-extension, together with weight and 
pulley, the upright at the foot to be eight inches wide and 
tall enough to lift the heel a few inches from the bed. 

To keep the broken limb steady he uses splints of 
strong tarboard, lined with cotton wadding and cotton 
cloth, placed next the skin and fitted to the thigh so as 
nearly to meet, one on the inside and one on the outside of 



Periscope and Abstract.* 117 

the thigh, and secured with bandages or cords. An air or 
feather pillow should be placed under the knee so as to 
elevate it about five inches, more or less, according to lo- 
cation of fracture. 

The Doctor claims that the above appliance for exten- 
tion and counter-extension gives freedom from bed sores, 
in that the weight of the body is kept somewhat off the 
bed; that it renders the patient more comfortable than 
any other with which he is familiar; that its use has in his 
hands never been followed by shortening of the limb, and 
that it is cheap. 



Membranous Croup. 



For child 6 years of age: 

5 Pil. pilocarpine mur. (1-30 gr.) No. 6 

Sig. One every two hours. 

Q Potass, permang. 12 gra. 

Potass chlor. 1% drs. 

Aq. 4 ozs. M 

Sig. Give a teaspoonful every hour, and use as a gan:- 
gle every half hour; also, 

5 Spts. ammon. arom. }4, oz. 

Spts. vini. gall. 1 oz. 

Aq. 3 ozs. M 

Sig. Two teaspoonfuls in water every two hours. Hot 
poultices to throat; the atmosphere moist with steam, and 
warm milk given freely. — Dr. W. H. Carleton in Medical 
World. 



*' Women are Dirty Creatvires, Anyhow." 

The above caption is that of an editorial in the Phila- 
delphia Reporter of May 31st, being a remark that fell from 
the lips of an old physician during a discussion in the 
Philadelphia County Medical Society. The writer proceeds 
to say that ''the remark was meant for the vagina,^'' and 
that the speaker went on to ask how many women ever 
syringe out the vagina, and yet how few there are who are 
exempt from some kind of vaginal or uterine discharge ! 
The practical advice suggested by this remark is that all 
women should provide themselves with a good suction 
syringe, and at every bath syringe out the vagina with soap 
and water. 

" Extended comment is unnecessary. These few words 
will suggest to every physician the propriety of such a pro- 
cedure, and will, no doubt, cause him to give such good ad- 
vice to all his female patients." 



118 The Peoria Medical Monthly. 

Incontinence of Urine. 

Of this troublesome affection, as occurring in children. 
Dr. Roberts Bartholow, of Philadelphia, has to say the fol- 
lowing in a clinical lecture at the Jeff. Col. Hospital, pub- 
lished in the Archives of Pediatrics for May. * * * 
" We have then two factors, the acid urine and relaxation 
of the sphincter. There may be still a third condition; 
namely, an abnormal contractility of the muscular layer 
of the bladder occurring during the period of sleep, and 
the will not being in action, the sphincter is over-powered. 
If there is this spasmodic contractility of the muscular 
layer of the bladder, the cause of it is, in all probabilityy 
to be found in the condition of the urine. The acid urine 
continually acting on the mucous membrane keeps up by 
a reflex effect and causes spasmodic contractions." 

" To these three factors a fourth might be added. 
There are but few cases of this fourth variety. Incontin- 
ence, or what is called incontinence, sometimes occurs be- 
cause the person habitually dreams of passing water when- 
ever the bladder is full. He feels the impression of the 
urine, but the sphincter still maintains its control. It is 
the brain which is at fault." * * * * 

In order to overcome the acidity of the urine, I pre- 
scribe the persistent use of some alkali, preferably an. 
alkaline salt of potassium. Nothing is better than the bi- 
carbonate in the form of an effervescent draught. We 
next need to give some remedy which will keep the 
sphincter in action. The best for this purpose is ergot. A 
pill containing one-fourth of two grains of aqueous extract 
of ergot, and with this may be combined advantageously 
one-fourth of a' grain of extract of nux vomica. 

A third thing may be done, that is, diminish the con- 
tractile power of the muscular layer of the bladder, and 
the bast remedy to accomplish this is a bromide. This is to 
be given in a single dose at bed-time to lessen spasmodic 
action. A bromide is particularly indicated in those cases 
in which the patient dreams of passing water. 

If the patient were anaemic we could not do better 
than prescribe the iodine of iron, which, under such cir- 
cumstances, is of decided benefit. 



Umbilical Hemorrhage. 

Dr. D. E. Smith, of South Hill, Ala., records a case of 
fatal umbilical hemorrhage, in Archives of Pediatrics, ow- 
ing to non-coagulability of the blood, and adds the follow- 



Periscope and Abstract. 119 

ing: It is with great regret that I have to chronicle this 
fatal case, because I an satisfied that, had intelligent assist- 
ance been at hand — which, unfortunately, was out of 
reach — the application of a closely-fitting styptic compress^ 
or a plaster-of-Paris cuirass; or, failing these, the insertion 
through the umbilicus of two needles at right angles to- 
each other, encircling each with a figure-of-8 ligature^ 
would have effectually arrested bleeding and saved the lit- 
tle patient's life. 

Again, had I been particular to instruct the nurse how 
she might, in the event of recurrence of hemorrhage^ 
pinch up the umbilicus between her index fingers and 
thumbs, and by firm and patient pressure stay the ebbing- 
life until the arrival of assistance, I confess that my regret 
for the issue would have been less poignant. It is because 
fatal cases are rare, and for this reason are apt to take us 
unawares, and because I wish my professional brethren ta 
be^-r in mind the possibility of their occurrence, their very 
unfavorable prognosis, and the most important measures 
for their relief, that I have asked the privilege of recording; 
the above case. 



Removal of the After-Birth. 

In a paper on the above subject, published in the 
American Journal of Obstetrics for May, Dr. H. J. Garrigues^ 
of New York, gives some statistics and personal experience 
bearing upon the efficiency of Crede's method of removing; 
the placenta, 

A record of four hundred cases at Maternity Hospital^ 
in which the placenta was expressed by Crede's method^ 
shows that in that number only six failed to be relieved^ 
and in those the after-births were tenaciously adherent^ 
and in two of them the danger from hemorrhage so great 
as to demand immediate removal and injections. 

Dr. Garrigues does not agree with Crede in considering- 
the retention of the membranes in the uterus as free from 
dangers. On the contrary, he considers it necessary in 
all cases to remove retained parts of the after-birth. He 
says: "By thoroughly disinfecting the hand, and follow- 
ing the removal of the membranes by an intra-uterine 
antiseptic injection, I have never seen any bad results, and 
I take the danger of infection to be smaller than that of 
hemorrhage and infection by leaving parts of the secun- 
dines behind. 

Formerly we used carbolic acid, a five-per-cent. solu- 



120 The Peoria Medical Monthly. 

tion for the hand and a two-per-cent. for the uterus, but 
;since Oct. 1st, 1883, when I introduced the bichloride of 
mercury treatment in the Maternity Hospital, we have ex- 
clusively used the latter drug in a solution of 1 to 2,000. 
In no case was any part of the placenta retained. 

Dr. Garrigues thinks " Cred'e's method recommends it- 
self by being modeled on the natural course of labor. It 
helps nature by employing her own means." The Doctor 
further claims that this method, by shortening the duration 
of the third stage of labor, and increasing muscular con- 
traction, counteracts hemorrhage immediately during the 
third stage and after the end of labor. 

" When properly executed, Crede's method of express- 
ing the placenta is the best prevention of post-partum 
hemorrhage." 

" Inversion of the womb, which is favored by pulling 
on the cord, is powerfully counteracted by the method 
recommended." 

'' The fearful avulsion of the whole uterus by pulling 
on the cord becomes impossible when the placenta is re- 
moved by pressure from above." 

This method should be used with the patient on her 
back. 

" Crede states that in two thousand deliveries the aver- 
age duration of third stage was four and a half minutes." 

In Dr. G.'s opinion it is of subordinate importance 
whether the third stage is allowed to last some minutes 
more or less. *' The chief point is that the uterus all the 
time be prevented from undue relaxation, that very little 
blood be allowed to accumulate, and that the placenta be 
removed by pressure." 



Morphia in Convulsions. 

Dr. William Fuller, in the course of a letter to the 
'editor of the children's department of the American Journal 
of ObdatricH, has the following to say in regard to the use 
of morphia in infantile convulsions: 

" I think that I have noticed that morphia is of little 
use in those convulsions which are attended with a con- 
tracted pupil during the fit, or where there is an excessively 
high temperature. 1 am persuaded that its use is positively 
•dangerous in those cases where 'the tendency to death' 
points primarily to a failure of the respiratory function, or 
in a condition where the capillary circulation is sluggish 
in a very marked degree. 



Periscope and Abstract. 121 

"I am afraid, in the same degree, to give morphia 
where there is a failure of the respiration, as I am to give 
jaborandi where there is a tendency to a sinking circula- 
tion. 

" 1 would not be understood that morphia is contra- 
indicated in stertorous breathing, but where there is a 
manifest debility or obstruction of that function continu- 
ing throughout the interval. Nor not always in this case, 
but only that a degree of caution is necessary, lest too 
great an insensibility of the respiratory centers be in- 
duced." 



A Model Unsanitary House. 

At the International Health Exhibition, one of the 
most amusing, and at the same time instructive, of the 
objects exhibited will undoubtedly be the model, on a large 
scale, of a house, illustrating every kind of sanitary defect; 
pan water-closets with "D" traps, baths and house maids' 
sinks in direct communication with the sewers; cisterns 
for drinking water, into which sewer gas is carfuUy sup- 
plied; badly made plumbers' fittings, un ventilated rooms, 
smoky chimneys, and many other similar evils, will doubt- 
less be fully represented among the apparatus of this house, 
and it will certainly be honeycombed with cess-pools, and 
undermined by leaky drains. This house will be contrast- 
ed with another, as perfect in every detail as the combined 
skill of the committee can make it. — Gaillard's Journal. 



Chilblains. 



The best remedy for chilblains is a mixture of one 
part, by measure, of tinct. iodine, and three parts glycer- 
ine. Apply with feather. 



Antiseptic Absorbent Sponge, 

Mr. Sampson Gamgee showed before the Medical So- 
ciety of London, April 21st, an artificial antiseptic sponge 
of his invention. A small capsule, containing eucalyptus 
or other antiseptic, was enclosed in absorbent cotton; out- 
side of this was a layer of eocoanut fibre, and outside of 
this more absorbent cotton-wool; the whole being enclosed 
in gauze. When about to be used the capsule could be 
Ijroken by a blow of the fist, and the absorbent cotton be- 
came permeated with the antiseptic. Mr. Gamgee said 



122 The Peoria Medical Monthly. 

that these sponp^es could be made at a very trifling cost^ 
and he hoped they would come into use as a cheap substi- 
tute for ordinary sponges; they possessed this great ad- 
vantage, and when required for use they were certain— 
however long they might have been kept — to be antiseptic; 
and, being so cheap, they might always be destroyed after 
being used. 



How to Liiniit the Spread of Scarlet Fever. 

Jamieson {Edinburgh Medical Journal, March, 1884), 
-thinks that very much can be done in this direction by the 
use of warm baths nightly, the body being afterwards, 
greased with an antiseptic ointment (the one which he 
himself employs contains 30 grains of carbolic acid and 10 
grains of thymol to the ounce), and by the regular applica- 
tion of a solution of boroglyceride to the throat. 

If these precautions are taken at the very outset of 
the disease and kept up through the entire course, cases 
which can not be thoroughly isolated may be rendered in- 
nocuous, so far as transmission of the disease is concerned. 
The author adds that all cloths and bedding should be 
steeped in a dilute solution of carbolic acid. — N. Y. Med^ 
Journal. 



Forcible Dilatation of the Orifices of the Stomach. 

Prof. Loreta recently dilated the cardiac orifice of the 
stomach for the ninth time. The patient, a young woman^ 
aged 20, had suffered for twelve months with a stenosis. 
w4iich allowed liquids to enter the stomach with the great- 
est difficulty. Life was only maintained by nutritive ene- 
mata. Prof. Loreta opened the abdomen, then incised the 
stomach and dilated the stricture. He closed the stomach 
and abdomen with separate sutures. The patient made 
an entire recovery. Soon after recovering from narcosis, 
she swallowed three spoonfuls of water with perfect ease. 



New Decrees. 



The Medical Record says: A dispensary in this city^ 
under homoeopathic auspices, has an annual commence- 
ment and grants degrees of ophthalmic and aural chi- 
rurgeon. — 0. d' A. Chir. 



During the first half of the present century. New York 
authors gave us 109 medical works. During the last thirty 
years they have added 236 volumes. 



Therapeutic Notes. 



123 



Slievaiifuttf gateis. 



CHANCRES AND OLD SOBES. 

5 Salicylic acid ^ oz. 

Iodoform K ^z. 

Cannabis indicg. 10 grs. 

Surgical collodion 1 oz.M 

In using shake well and applj' 
with a small brush. — American Med. 
Journal. 

HEMORRHOIDS. 

As a local anaesthetic use : 

Etheris sulph 2 ozs. 

Oamphorae 2 scruples.M 

Sig. External application. 

OIMTMENT FOR HEMORRHOIDS. 

Acidi tannici ' 1 dr. 

Hydrarg chlor. mit. 1 dr. 

01. lini 2 dr. 

01. origani 2 dr. 

M. Sig. Apply externally, — Thera- 
peutic Gazette. 

SEBORRHOeA SICCA. 

5 Zinci oxidi 1 gr. 

Sulph. prsecip. 1 gr. 

Ung. simp. 1 oz.M 

The ointment should be applied to 
the head each evening and washed off 
in the morning. — A/nc. Med. Digest. 

ORCHITIS. 

5 Liq. amnion, acetat. 1 oz. 
Spir. aetheris 114 oz. 

Mist, camph .8i| oz.M 

Sig. To be applied by means of 
a single fold of linen, which is con- 
tinuously wetted with the fluid — JJr. 
J. L. Milton. 

[ Note. We have used this lotion 
in several cases where the pain in the 
testicle was insense, and with the 
happiest results. Patients report it re- 
lieved them like magic. Ed.] 

LINIMENT FOR WEAK BACK. 

IJ Tr cantharidis 4 oz. 

Tr. camphor 4 oz. 

Oil of cedar 1 oz. 

Turpentine 4 oz. 

Ammonia water 4 oz.M 

Sig. For external application. — Dr. 
P. M. Dromgold in Med. World. 

SUMMER DIARRHCEA. 

Ij Lactopeptine 96-160 grs. 

Subnit bismuth 96-160 grs. 

Acid nit. (C. P.) 32 drops 

Syr. rhei. arom. 1 oz. 

Aq. camp. q. s. ad. 4 oz.M 

Sig. Teaspoonful in water after 

each flux from the bowels. Tr. opium 



may be added to the above if necessary. 
—Dr. C. S. Rozzell in Med. World. 

CHOLERA INFANTUM. 

5 Ingluvin 25 grs. 

Dover's powder 10 grs. 

Epsom salts 1)4 '^^'S- 

Soda bicaib % ^'■• 

Water 6 oz.M 

Sig. Teaspoonful to teaspoonful and 

a half every hour. Shake well. — Dr. 

J. B. Murphy in Med. World. 

SEXUAL DEBILITY. 

5 Fl.ex. arislol. serpentaria 2 ozs. 

Acid phosphor, dil. 2 ozs. 

Fl. ex. nucis vom. 23^ drs.M 

Six. Teaspoonful 3 times daily. — 
Dr. H. G. Blaine in Medical World. 

PRURITUS VULVE. 

5 Powd. borax K oz. 
Sulphate of Morph. 6 grs. 

Decoction of hydrastis 8 ozs.M 
Use as a local application 

DIARRHCEA MIXTURE. 

IJ Tine, catechu 2 drs. 

01. pepperment 6 min. 

Fl. ext. opium 13 min. 

Chalk mixture to make 4 oz.M 

Sig. Teaspoonful every time the 
bowels are moved. 

INFANTILE COLIC. 

5 Tr. assafojtida 15 drops. 

Tr. cinnam. % o^. 

Soda carbon. 1 dr. 

Syr. rhei. arom. 3 dr. 

Aq. m ozs.M 
Sig. Half teaspoonful every three 
hours. 

SULPHUR OINTMENT. 

5 Sulphur 1 fc. 

Lard 4 ft.s. 

Oil of bergamot 2 dr.M 

Sig. Apply to aff'ected parts. 
The above four formulae are by Dr. 
J. W. Stockton in California Medical 
Journal. 

RHEUMATISM. 

IJ Acid salicyl. 2 dr. 

Potass, acetat. 4 dr. 

Syr. limonis 1 oz. 

Ex.tongae fl. 4 dr. 

Aq. menth.pip. 1 oz. 

Aq. anesi. q. s. ad. 8 ozs.M 

Sig. Two teaspoonsful every two 
hours till relieved, or until four or five 
doses are taken. After that give at 
longer intervals. Give with water. — 
Dr. C. H. Hughes in Medical Review. 



Peoria Medical Monthly. 

THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publisher, 

204 South- Jefferson Street. .... PEORIA. ILL 

*»*The Editor is not responsible for the statements or opinions of contributors 

***Sliort original articles are invited from any reader, whether a subscriber or not. 

*,*If extra copies are desired by a contributor, the number must be specifled when 
the article is sent in to the Editor. 

^•, All exchanges, books for review, and communications must be addressed to th9 
Kdltor and Publisher. 

»*#The publication day of this journal is on or about the 15th ol each month. 

»**To subscribers! A pencil mark at this place indicates that the time of your sub- 
scription has expired, and that a prompt renewal is urgently requeiited. 



The Introduction of Sections into the Illinois State Medical 

Society. 

To those who have regularly attended the meetings of 
our State Society for the past few years, the necessity for 
some form of reorganization in its methods of work is ap- 
parent. 

The society has outgrown the methods of a district, 
county or city society, and the increasing number of vol- 
unteer papers, often times of great value, demands a more 
systematic order ot business. 

It is needless to refer to the methods of the American 
Medical Society, or many of the State Societies in the East, 
as they are familiar to all, and no argument is needed to 
prove the value of sectional work. 

Our society is already equipped with all necessary com- 
mittees, chairmen of the same, and the division of the 
meetings into sections will not interfere in the least with 
its present plan of organization, any further than to com- 
plete the same. The founders of the society evidently con- 
templated the growth of the society when formulating the 
order of business, and probably intended a division into 
sections as soon as the increased membership, and number 
of papers to be read, demanded it. 

We believe that the time has now come, and that it 



Editorial Department. 125 

will be to the best interests ot our society to adopt it; at 
present in a somewhat modified form, suited to the present 
requirements of the meetings. 

We propose to advance a plan for this improved order 
of business, and hope to call out a general expression of 
opinion on the subject, that the question may be fully dis- 
cussed and plans matured by the time ot the Springfield 
meeting next year. 

Leaving out the Committee on Necrology, we then 
have six standing committees: 

Practical Medicine, Surgery, Obstetrics, Gynecology, 
Ophthalmology and Otology and Materia Medica and 
Therapeutics. 

These six committees can be naturally consolidated 
into three without losing their importance or rank. 
Hence these sections could be formed as follows: 

1st. Practical Medicine and Materia Medica and 
Therapeutics. 

2d. Surgery and Ophthalmology and Otology. 

3d. Obstetrics and Gynecology. 

To these sections could be referred all special commit- 
tees and volunteer papers, with reference to the subjects 
of the same. 

Now as to the division of the time to be allotted to 
general sessions and the three sections. 

The three days of meeting, as divided under present 
arrangements, give us about seventeen hours in which all 
the business of the society must be transacted, and all pa- 
pers read, with their discussion following. 

If an evening session be held the first day, as is some- 
times done, two hours may be added, making nineteen 
hours of work out of the three days of meeting. 

By the plan which we would propose, it will be seen 
that it is possible to secure thirty-six hours of work, or to 
just about double the working hours of each meeting. 

Under this plan, too, sufiicient time will be given for 
all general business, all new business and the reports of 
the chairmen of the six standing committees, including 
those on Necrology and Legislation, to be read in general 
session. 



126 



The Peoria Medical Monthly. 



It will do away with entertainments; but they are not 
what we give three days of our time to attend. 

We herewith append a schedule, drawn up on this 
plan, which will convey our meaning better than pages of 
general explanation: 



OKKSBAL SESSIOir : 

9:30 to 12 

A.M. 



SECTIONS : 

1:30 to i 

P.M. 



OKNEBA.L SB89ION : 

7:30 to 9:30 

P.M. 



TUESDAY. 

FIRST DAY. 

Organization; Com. on 
Arrangements ; Presi- 
dent's Address ; Mis- 
cellaneous and New 
Business. 



Sec. on Practical Med- 
icine. 
' " Surgery. 
" Obstetrics. 



Com. on Necrology. 
" " Legislation. 



"WEDNESDAY. 

SECOND DAY. 

General Business ; Re- 
port on Practical Med- 
icine; Report on Surg- 
ery; Nominating Com- 
mittee. 



Sec. on Mat. Med. and 

Thera. 
' " Ophthal. and 

Otology. 
' " Gynecology. 



Report on Obstetrics. 
" Mat. Med. 
and Thera. 



THURSDAY. 

THIRD BAY. 

Report of Nom. Com. 
" on Gynecology. 
" '■ Ophthal. and 
Otology. 



1:30 to 4. 
Sec. on Prac. Med. and 
Mat., Med. and Thera. 
Sec. on Surgery and 
Ophthal and Otology. 
Sec. on Obstetrics and 
Gynecology. 



4 to 5 
General Session 
Adjournment. 



and 



We hope all interested in the welfare ot oar State 
Society and its improvement will give this subject careful 
attention, and suggest any changes that may seem desir- 
able. We offer our pages for a full discussion of the sub- 
ject, and hope it will be sufficiently general to bring about 
the desired ends. 



Tetanus Following- Heaton's Method for the Radical Cure of 

Hernia. 

We believe that its harmlessness is one of the chief 
claims of the advocates of this method of curing rupture, 
the chief among whom is Dr. Jos. H. Warren, of Boston. 

But within the past few months we have learned of 
two cases in which tetanus and death followed this opera- 
tion. 

We do not know the particulars of either of these 
cases, further than that they were both operated on by the 
same operator, and in a short time died of this disease. 

A third patient was brought near to death by a very 
severe phlegmonous inflammation of the whole leg, but 
finally recovered. 

We hope any who know of any such cases will report 
them promptly, that the possible dangers of this, to many 
fascinating operation, may be fully understood. ! 



Editorial Department. 127 

**Home Health." 

We call especial attention to the following notice 
taken from the last issue of the Weekly Medical Review: 

" Home Health, originally published by Dr. T. M. Mc- 
Ilvaine, of Peoria, 111., has passed into the hands of J. H. 
Ohambers & Co., and publication of the popular periodical 
will be resumed early this fall, at which time all the old 
subscribers will be supplied and as many new ones as may 
meantime send in their orders." 

We know that Chambers & Co. have had considerable 
trouble in arranging for the resumption of our pet project. 

They contemplate many improvements, and these take 
time to provide. 

We confidently promise that all pledges made either 
\>j ourselves or Messrs. Chambers & Co. will be strictly ful- 
filled. 



A Substitute for Dover's Powder. 

A medical friend of over forty years practice gave us 
this formula for an improved Dover's Powder. He used it 
for over twenty years, and those of his friends to whom he 
gave the formula were highly pleased with it. Its chief 
merit is its pleasant taste; its effects are identical: 

Pulv. ipecac 1 grain. 

Ant. et pot. tart. 1-12 grain. 

Morpliia sulp. 1-6 grain. 

Pulv. ginger 1-4 grain. 

Sugar to make 10 grains. 

Triturate thoroughly. Dose the same as Dover's Pow- 
der. Try it. 



Military Tract Medical Society. 

The semi-annual meeting of this Society, was held at 
Galesburg, 111., May 13th. The sessions were well attended, 
and a number of able papers read, and discussed. 

The following officers were elected for the ensuing 
year: President, Thos. Temple, Cameron, 111.; -Vice Presi- 
dents, J. H. Wallace, Monmouth, T. A. Scott, Oneida ; Sec- 
retary and Treasure, H. C. Hopper, Galesburg. 



128 The Peoria Medical Monthly. 

Notes and Comments. 

Send in reliable formulae, that our " Therapeutic 
Notes'' may be wholly original. 

The enlarged journal has been received even better 
than we hoped for. It is a success. 

Dr. B. H. Davenport, of Nanticoke, Pa., fell dead, a 
few weeks ago, while dressing a wound. 

A. A. Mellier & Co., of St. Louis, have sent us a very 
handsome catalogue of surgical instruments. 

The new hospital adjoining Rush Medical College will 
probably be ready for the admission of patients early this 
fall. 

We are indebted to the Weekly Medical Revieiv for our 
reports of the meetings of the Iowa and Missouri State 
Societies. 

The Travelers' Insurance Company, of Hartford, has 
sent to the "American Press" a handsome colored litho- 
graph of Bartholdi's Statue of Liberty. 

Dr. Thos. J. Griffiths, a prominent and popular physi- 
cian of Louisville, Ky., died June 1st, aged fifty-eight years. 
He was for several years surgeon in the Marine Hospital 
Service. 

."Plough on Rats" is becoming a favorite means of 
suicide. Several cases have been recently reported in dif- 
ferent journals. The stuff" is said to be mainly composed 
of aisenic. 

A Chinese doctor is practicing with great success at 
Deadwood. Patients come from all surrounding towns, 
and their remains are often sent home to their weeping 
friends by express. — Daily Journal. 

The warm weather of the summer season is not calcu- 
lated to bring out many long articles, but there is no sea- 
son in which more good can be accomplished by short, 
practical articles on the treatment of summer diseases, re- 
ports of cases, etc., for which " Our Clinical Society " is al- 
ways open. 



Editorial Department. 129 

The funny bone is said to be so called because it is the 
end of the humerus. 

Dr. Geo. N. Kreider, of Springtield, has been appointed 
member of the Illinois State Board of Health. 

Dr. Wm. Pepper has been elected to Chair of Theory 
and Practice in the Jefferson Medical College, to succeed 
Dr. Alfred Stille. 

Increased size in our journal means to our readers just 
that much more reading matter; to us it means increased 
responsibility, labor and expense. We hope this will be 
appreciated. 

The following verdict was found (and ought to be pat- 
ented) by a coroner's jury recently: "The late deceased 
had come to his death by a blow on his head, inflicted 
either before or after he was drowned." 

Cards on our table announce the marriage, on May 
15th, of Dr. D. Warren Miller, of Gilman, 111., to Miss Clara 
E., daughter of Dr. Raney, ot the same place. We extend 
our cordial congratulations to the Doctor and his bride. 

A public spirited doctor in Cincinnati distributes in- 
structions as to what should be done in cases of poisoning, 
and after giving the antidotes, adds, "but lose no time in 
sending for a competent physician at No. street. 

Recent decisions in two cases, one under the act to 
Regulate the Practice of Medicine in Illinois, the other 
under the Dental Surgery act, sustain the right of the State 
Boar^ of Health to determine the status, both of a college 
and of a practitioner. 

We return hearty thanks to the large number of our 
subscribers who so promptly responded to the renewal 
statements sent out a short time since. We hope the re- 
maining few who have not yet responded will look over 
the statement and attend to it promptly. 

Medical College of Ohio. — The faculty of the Medical 
College of Ohio has decided to hold a preliminary examina- 
tion of all candidates for admission to the lecture classes, 



130 The Peoria Medical Monthly. 

in the absence of a diploma or other evidence of sufficient 
literary training. A chair of hygiene has also been added. 

A new sect has been started in Boston which holds 
that disease is caused by the absence of God from the hu- 
man body, and that a man who has God in his body can 
cuie those who are ill by touching the spine of his back 
against theirs. — Daili/ paper. 

A bill recently introduced before the Senate off'ers a re- 
ward of $100,000 to any person who shall discover the true 
germ of yellow fever, or any certain way of preventing its 
spread or modifying its virulence. Here is a chance for the 
germists — but the bill has not yet passed. 

We have some extra copies of the Journal on hand 
for distribution. If any of our readers will take the 
trouble to send us the names and addresses of some of his 
medical friends and acquaintances, we will mail to each of 
them a copy. In this way our subscription list can be in- 
creased and the journal placed in the hands of those who 
otherwise would never see it — to their great loss as a mat- 
ter of course. 

Dr. (?) Franklin Pierce, of Worcester, Mass., is under 
indictment for causing the death of a patient. Being a 
strong believer in the efficacy of petroleum in all diseases, 
he wrapped his patient from head to foot in cloths sat- 
urated with the oil, and kept them saturated without re- 
moval. This heroic treatment was too much for his 
patient and she died. We do not know the nature of the 
malady for which the petroleum was used. 

The Agenfs Herald published by L. Lum Smith, Phila- 
delphia, has done a grand work in exposing advertising 
frauds, and is now engaged in the equally laudable work of 
making tricky publishers give correct circulations. It is 
an easy matter to claim a big circulation, but it is a fraud 
to sell advertising space based on false statements of circu- 
lation. There are some medical journals (not many, we 
are happy to think) that might be taught a wholesome les- 
son by Mr. Smith. 



Editorial Department. 131 

First Country Doctor — " Could you come to my place, 
Brown, to-morrow?" 

Second Country Doctor — " All right, old man, what is 
it?" 

First Country Doctor — " Well, I've had a case of en- 
docarditis, which Fve very successfully treated with con- 
vallaria majalis, and I want your help with the post-mor- 
temy 

The June number of the Chicago Journal and Examiner 
reached us June 10th, or about twenty days after the meet- 
ing of the State Society, but not one word concerning the 
meeting did it contain. For enterprise, the Chicago jour- 
nals lead the field. 

The same may be said concerning the Journal of the 
American Medical Association. It promised a report of the 
State Society meeting, and we suppose it will come some 
where between now and .Christmas. 

Dr. Edward W. Jenks announces that he is about to 
return to his old home in Detroit, Mich., after an absence 
of about five years. He will close his Sanitarium, Spring- 
brook Place, at Geneva, III, June 1st, and will re-establish 
it in or near Detroit. Detroit is to be congratulated on re- 
gaining one of the foremost gynecologists in the country, 
and whose name is known all over the world. 

We sincerely hope the change will effect the desired 
improvement in health, that is the immediate cause of his 
removal from Chicago. 

Dr. Leartus Connor delivered a very interesting ad- 
dress before the American Association of Medical Editors, 
on the " American Medical Journals of the Future as in- 
dicated by the history of American Medical Journals in 
the Past." 

From it we learn that since 1797, 509 journals of all 
schools have been started and 373 have ceased, leaving 
about 135 current at the present time. 

Since 1879, 129 regular medical journals have been 
started, of these 5 issued but one number, 25 did not com- 



132 The Peoria Medical Monthly. 

plete the first volume, 37 did not go beyond the first 
voliune, and 49 did not go beyond the second volume. 

This is not encouraging to those who have aspirations 
towards publishing a medical journal, and makes us feel, 
with our fifth volume, as one of the aged ones. 

Dr. Connor further states that " medical journalism is 
just now passing through an epidemic of cheap medical 
journals, cheap 'in every sense, cheap in price, trom $1 to 
nothing, cheap in make-up, in paper, in press work, in edi- 
torial work, in contributed articles;" but he also believes 
that this epidemic will be safely passed through, and that 
medical men will be willing to pay what a journal is worth. 
There are many valuable ideas in Dr. Connor's paper, and 
we shall refer to it again. 



Chicago Jottings. 

The meeting was a fair average of the past meetings 
of the society, but a very poor one compared with what 
the meetings of the Illinois State Medical Society should 
be, and we firmly believe will become. 

Professor Andrews made in many respects a good pre- 
siding officer, but in his great eagerness to dispatch busi- 
ness seemed to discourage rather than invite discussions of 
the papers read. 

Chicago physicians (there are said to be about 800 of 
them), made a very poor showing at the meeting. We do 
not believe there were ever more than thirty or forty of 
them at one session — except the banquet. Perhaps their 
absence would mdicate that the meetings of our State So- 
ciety are not held in very high repute by the non-attend- 
ing part of the profession. If so, can not and must not 
this be changed, so that it will be considered an honor and 
a privilege to attend and take part in its proceedings ? 

We would propose that the delegates to the various 
affiliating societies l^e nominated by the same committee 
that selects our officers and committees. 

A motion to appoint all members of the Chicago Medi- 



Editorial Department. 133 

€al Society as delegates to New Orleans would have saved 
much time and the president much breath. 

The banquet tendered by the physicians of Chicago to 
the members of the State Society was one of the most ele- 
gant of its kind. The supper was superb, skillfully served 
and heartily enjoyed. The music was splendid, especially 
that furnished by the Chicago Male Quartette. Dr. Chas. 
Gilman Smith was master of ceremonies, and presided 
over the mental banquet with grace and urbane dignity. 

The responses to toasts were apt and far from dry. 
The press was ably represented by Eugene Field, the well 
known " funny man " of the News, who gave us a poem 
that was full of dainty fun about and pathetic allusions to 
the " old doctor." 

General I. N. Stiles represented the Bar and was 
heartily applauded. 

Rev. E. C. Bay showed himself to be both well versed 
in modern science and a valiant upholder of the faith he 
teaches. 

Dr. Robert Boal of Peoria, from the high vantage 
ground of fifty-six years of active practice, cast a back- 
w^ard glance, and drew from memory pictures of the doctor 
ot many years ago. May his step still be as light, his smile 
as cheery, and his heart as youthful for many, many years 
to come. 

Other speeches were made, but space forbids their 
special enumeration. 

Dr. N. S. Davis closed by one of his peculiar addresses 
that must be heard to be appreciated. 

The banquet was a grand success, and we hope it will 
be the last for some years to come. 

Why ? Because we hope to see the second evening of 
each year's meeting devoted to practical work, until such 
times as our society shall have attained the size and posi- 
tion it ought to have, but not yet possesses. 

The exhibitors complained most bitterly of the treat- 
ment they received at the hands of the Chairman of the 
Committee of Arrangements. They rented a hall for 



134 The Peoria Medical Monthly. 

about $50; at his solicitatiou they gave up their lease to 
Committee of Arrangements, and then the committee made 
them pay from $15 to |25 each for space. This fine scheme 
on the part of the Committee, or its chairman, netted the 
committee about $150 clear money. 

The treatment exhibitors received at Peoria a year 
ago, was frequently brought up, and not to Chicago's credit. 

There is altogether too much autocracy assumed by 
some members of the society. They run things to suit 
themselves, and anyone v^ho attempts opposition gets 
severely snubbed, in a smiling way it is true, but neverthe- 
less snubbed. 

Many members w^ho did not have the pleasure of hear- 
ing Dr. Charles T. Parkes' paper read before the American 
Medical Association at Washington, desired to have him 
give a 7'esume of it, and exhibit the preparations and illus- 
trations shown at Washington. The Society, on motion of 
Dr. Wm. A. Byrd, of Quincy, voted to hear it, but somehow 
somebody managed to prevent its hearing. We do not 
know who was to blame for this, but we do know that it 
was a disgrace to the Society to invite Dr. Parkes to do 
it this honor, put hiin to the trouble of making consider- 
able necessary preparation, and then refuse to hear him, 
because somebody didn't want him to have the honor. 

The southern part of the State carried off the honors 
of president and next place of meeting, and we hope the 
physicians in "Egypt" will turn out en masse to show their 
appreciation of the honors, and make the society what it 
chould be, a truly representative body of regular physi- 
cians. 

We do not mean that it is not representative as far as 
it goes, but it does not go far enough: there are not enough 
who take the interest in it that should. It ought to have 
a membership of 2,000 and a yearly attendance of at least 
half that number. Let us all work together to that end, 
and do what we can to accomplish it. 

Those members and delegates who stayed at home be- 
cause it was too far to travel or because it would take too 



Editorial Department. 135 

much of their time, should be rebuked by the prompt at- 
tendance of Dr. Roswell Park, who has within the past 
year removed from Chicago to Buffalo, New York. Last 
year he was appointed chairman of the committee on 
Surgery, and he did not think the distance too great to 
break his engagement with the Society. Have all who 
stayed at home a better reason than he could have offered? 

The exhibits of drugs and pharmaceutical prepara- 
tions, while not extensive, were very interesting and at- 
tracted considerable attention on the part of delegates and 
members. 

Parke, Davis & Co. had a line line of new remedies, 
showing both the crude form and the finished goods. 
Their samples were apparently highly prized, especially 
cascara cordial, which we have found a most efiicient laxa- 
tive. 

Mellin's Food exhibit of Dolliber, Goodale & Co. was 
surrounded by crowds. The food is not excelled by any in 
the market. 

Fairchild Bros. & Foster called especial attention to 
their Extractum pancreatis for partially digesting milk for 
infant feeding. 

McKesson & Robbins exhibited pills of their well 
known alkaloidal preparations. 

Schieffelin & Co. had a very fine display of pills. 

W. R. Warner & Co. paid especial attention to Par- 
vules, calling the attention of physicians to this superior 
method of gaining exact results from small doses of the 
alkaloids. 

J. & W. Horlick & Co. exhibited their Infant's Food, 
and called especial attention to their well known Dry Ex- 
tract of Malt. 

J. H. Chambers & Co. sold many volumes of their well 
known publications, especially "Shakespeare as a Physi- 
cian," and "Labor Among Primitive Peoples." 



136 The Peoria Medical Monthly. 

Receipts. 

Any one who has forwarded money during the month, 
not otherwise receipted for, will please notify the publisher 
at once, if his name does not appear on this page in the 
next issue: 

Illinots— Drs. A. B. Strong ($2.00), W. A. Byrd ($2.00), Silas Hubbard, 
C. T. F. Stringer, J. F. Todd, A. K. Van Horn, H. S. Bell ($2.00), J. S. Blank- 
euship (S2.00), X. F. Felker, D. F. Rupp, A. R. Small, J. J. Thometz, W. F. 
O'Brien, C. Barlow, J. E. Charles, H. T. Coffey, W. R. Hamilton, A. N. Warren 
($2.00), F. C. Robinson, J. N. Niglas, Ellen Ingersoll, H. Giilick, B. H. Har- 
ris, D. W. Aldrich ($2.00), W. H. Jones (tm)}, B. Eagon ($3.60), a. V. 
Black ($3.00), M. W. Skinner, A. R. Graham, W. N. Cline, H. M. Boldt, J. N. 
Speed, C. M. Miller, L. E. Keeley, Ch. H. Carter, E. E. Reynolds, C. F. Ross, I). 
P. McClure, Thos. Temple, J. Lee, A. G. Humprey, J. H. Wallace, J. H. Tyler, 
Jno. Alsop, W B. Mizell, E. H. Henry, F. C. Gay, C B. Maclay, A. Hess, D. W. 
Miller, W. H. Veatch, W. R. Barker, L. B. Martin. A. M. Bird, J. L. Martin, G. 
L. Corcoran, F. P. Anthony, L. H. Cohn, $8.00), J. Wills (2.00), Jno. P. Seebold, 
W. Wilson. E. R. Boardman, W. V. Glittery, J. Henry, C. T. Dripps, W. W. R. 
Woodbury, J. T Stewart ($2.00), H. M. Hall ($2.00), D. McCreel ($2.00), S. A. 
Hopkins, Anna S. Adams,, N. Holton ($1.50), C. M. Baker, W. H. Eldred, J. B. 
Carver, W. G. Piersol, H. H. Littlefield, Juo. Becker, F. J. Shipp, P. A. Rosen- 
berger, L. G. Thompson, Lee Smith, John Farrell, C. K. Hendee, W. K. New- 
comb, C. G. Wheat, Nathan Holmes ($2.00), D. T. Stewart, A. F. Burnham, E. G. 
Davis, J. H. Timkins (S3.00), W. J. Thurman. 

Minnesota— Dis. R. L. Moore, H. G. Murdock, B. F. Fuller ($1.50), F. H. 
Welcome. 

Oregon— Dr. N. J. Sullivan. 

Wisconsin— Drs. F. C. Malone, F. H. McNeel, D. W. Lynch, O. N. Murdock, 
J. 3[assman, S. A. Mellen, C. H. Frost. 

Dakota— Dr. G. W. Nuckols, D. M. Slemmons. 

Iowa— Drs H. C. Hull, J. B. Galer ($2.00), A. J. lilitcliell (-i.bO), F. L. 
Searles, C. C. Farrell, W. H. Robert.-^ ($2.00), W. PL Merritt ($2.00), T. J. Max- 
well (2.00), J. Cal. Williams ($2.00;, J. M. Payne, J. B. Gardner (2.00), J. S. Or- 
miston, Edw. Scliitrerle, Emil Brendel, W. G. Dwyer. 

Ohio— Drs. David Mason, J. Harrison. 

Mrssot:ui— Drs. S. F. Bonney, J. R. Yates, J. Seevers. 

Nkbkask.\— Drs. L. B. Allen, S. W. Dodge, J. Hoover. 

Mkiikian- Dr. A. Garwood. 

Pennsylvania— Dr. S. A. Suloff. 

Kkntickt— Drs. Duncan 6: Douglass, W. L Moore, C. H. Hubbard (2.00.) 

Camfoiinia— Drs. (). B Adams ($2.00), W, V. Grimes. 

WAHiirNfrroN Tkiuutokv -Dr. R. Cummins (.S4.0() ) 

Wyomi.v; TEnRiTDUv— 'I'. H. Webb. 

Indian TKRRrrouv — Dr. J. R. Brewer. 

Kansas— Drs. C. C. Corkins, D. C. Tvler, T. J. & A. A Cowrv, D. W. Maxon 
(2.50.) 

NoiiTir Caiiomna- Dr. 11. W. Lilly. 



The Peoria 
MEDICAL MONTHLY, 



Vol. V. AUGUST, 1S84. No. 4. 



©vigiual (fUommuniation^. 



Art. I.— Impacted Fseces. By O. B. Will, M. D., Peoria, Illinois. 

During the past month I have encountered the fourth 
€ase of impacted faeces mistaken for uterine or ovarian 
tumor, which has come under my observation. 

Cases of fgecal accumulation of merely days, or even I 
might say weeks, which frequently occur, are not included 
in this enumeration. The cases referred to are those in 
which the accumulation had been gradually taking place 
for months, the rapidity of increase being such as to suggest 
reasonable grounds for the opinion that it was the growth 
of one or other of the tumors for which the condition was 
mistaken; the whole presenting a state of affairs well 
calculated to deceive even the elect of the profession. 

My most lively attention was first called to this subject 
several years ago, in consequence of being applied to by 
the parent of a young and single lady for something to 
give the latter relief from a distress in the bowels to which 
she had been predisposed for a year or more on account of 
the existence of a uterine tumor which was continually 
increasing in size, which medication failed to influence, and 
the pressure from which occasioned much suffering and 
rapidly declining health. 

An examination of the tumor served to render me 
somewhat skeptical in regard to its character; not so 



204 The Peoria Medical Monthly. 

much in consequence of my diagnostic ability, as the sug- 
gestiveness ot an experience which I remembered having 
seen reported by Dr. J. H. Thompson, surgeon-in-chief of 
the Columbia Hospital for Wc men, in the report of the 
latter institution for 1872. 

After a re-reading of the history of Dr. Thompson's 
case, I was more deeply than ever impressed with the idea 
that the tumor with which I had to deal was one of fascal 
character; and after a second thorough examination and 
consideration of the S5miptoms of the case, I imparted to 
the patient and her friends my belief as to such being the 
nature of the malady, and my desire to 'test its correctness 
by treatment suited to such condition. The proposed 
course was heartily indorsed by them, and I entered with 
some enthusiasm upon the work. 

In so far as the further history of this individual case 
is concerned, suffice it to say that the result of the treat- 
ment proved the correctness of the diagnosis, and led me 
in two or three other cases to ferret out identical condi- 
tions, in the face ol opposition under which I would have 
given way had it not been for my experience as above; 
and also led me to mention the . main facts through these 
pages in order to suggest a possible clue to the mystery 
which may surround the diagnosis of cases under the 
supervision of some of my readers. 

In each one of the several cases above mentioned there 
existed a sallow complexion, some emaciation and feeble- 
ness. Pain was complained of in the side and down one or 
both thighs, and, as in the case of Dr. Thompson's patient 
above referred to, the tongue was heavily coated, breath 
foetid, and bowels troublesome in that there were frequent 
watery mucus passages, which latter only added to the 
deception and served to distract the physician's attention 
from the true state of affairs. Pain in the back was con- 
stant, urination frequent but not painful. There were no 
solid passages from the bowels in a long time, and then 
very slight. In all the cases the stomach was very irrita- 
ble, rejecting the food readily, only a little milk or soup 



Original Communications. 205 

being retained, and that necessarily administered in very 
small quantities. 

The local examination in each case revealed a tumor 
above and in the rear of the uterus, pressing down and 
fixing the latter low in the pelvis and anteriorly. It was 
almost absolutely immovable. The sound introduced into 
the uterus showed a normal depth, and an antefiexed condi- 
tion. All attempts to introduce a catheter, (into the rec- 
tum) to any distance were futile. The abdomen was in 
each case very greatly distended, with considerable tym- 
panitis above and to the right side, although in two of the 
cases a considerable degree of impaction was detectable in 
the ascending and transverse portions of the colon, and 
served in a measure to simplify the diagnosis. 

There had never been any uterine hemorrhage in 
either of my cases, but in each one menstruation was 
scanty and quite painful. The following paragraph from 
Dr. Thompson's description of his case is quite applicable 
to each of mine: 

"Upon turning the patient upon her right side and per- 
cussing deep in the left ilias fossa, no tympanitic sound 
could be discovered indicating the presence of intestine, 
nor could the tumor be pressed over toward the right side; 
it was firmly bound down in the fossa. The symptoms 
were all negative: no positive diagnosis could be made. 
The tumor v/as too tender for ovarian, nor was it suffi- 
ciently large to have produced such an amount of interfer- 
ence with the functions of the abdominal organs as would 
cause the severe constitutional disturbance under which 
the patient was suffering." 

The treatment adopted by me in each of the three 
cases immediately under my care, was in the main that of 
Dr. Thompson, viz: The use of the belladonna supposi- 
tory, (1 to 3 grains) with injections of sweet oil and 
glycerine (1 ounce of each) frequently repeated, so as to 
lubricate and preserve the rectum as much as possible from 
injury. Clreat caution was used in the use of the bella- 
donna, its effects being watched closely and the drug with 



206 The Peoria Medical Monthly. 

drawn for a time when constitutional or local disturbance 
indicated. 

The irritability of stomach was sufficiently great in 
only one of my cases to render necessary a resort to injec- 
tions of beef tea. In all, the return to solid food was 
gradual. Vegetable bitters and quinine were used through- 
out, and great care exercised to keep the bowels well 
emptied for some time after the removal of the impacted 
mass. The impacted masses consisted of quantities of 
scybalus faeces, coated with mucous, the latter in numerous 
cases streaked with blood. 



(D»r (ffiUttial ^ofUty. 



[For this department we hope to enlist the co-operation of our friends. Short reports of 
interesting cases are especially requested from every one. We would like to have twenty or 
more such articles for each number. See editorial in No. 1, Vol. V, May, 1884.] 

Art. II.— Glossitis. By J. F. Corbett, M. D., Weyanwega, Wis. 

The following case of Idiopathic Glossitis may be of 
interest: 

Was called to see Mr. H. J., 45 years of age, who the 
day previous was taken with a chill . immediately followed 
by high fever and extreme pain and swelling in the tongue, 
the organ was greatly swollen and its edges deeply indented 
by the teeth; there was a profuse flow of saliva and intense 
thirst, but almost inability to swallow or speak. 

The patient had on the first appearance of the symp- 
toms taken a saline cathartic. I ordered hot applications 
to the throat and prepared a solution of chlorate ot potas-- 
slum for a mouth wash, and a mixture ot aconite to be 
taken as best the patient could. 

At my next visit in 24 hours, I found the symptoms all 
greatly exaggerated, the appearance of the patient was most 
unsightly and distressing, the tongue constantly protruding 
from the mouth, intense pain, and an incessant flow of 
saliva, respiration and imlse rapid, suffocation and even 
gangrene threatening. 



Our Clinical Society. 207 

I immediately made two free longitudinal incisions 
along the dorsum of the tongue on each side of the raphe 
which was followed by the escape of blood and infiltrated 
serum. 

I then ordered warm water to be used as a mouth 
wash. This was followed by some relief to the patient, but 
the inflammation and swelling subsided very slowly. His 
tongife has ever sii^pe been somewhat hypertrophied; there 
was no history of syphilis or mercurial salivation. 

The points of interest are, the sudden development of 
the case, the gravity of the "symptoms and no assignable 
exciting cause. 



Abt. III.— Prolapse of the Bladder. By S. W. Dodge, M. D., Endicott, Nebraska. 

July 9th, 1883. Was called to see Mrs. C. in her 
twelfth confinement: forty-six years of age, large, strong 
and swarthy. Informed me that in her last three labors 
she had had "fits" and was as "crazy as a bed bug" from 
time pains began till she was delivered; furthermore she 
had never had a Doctor before and I was expected to 
prevent the "fits" this time or she would "die sure." Pro- 
ceeded to make examination per vagina: found labia much 
swollen, vulva large, hot and dry. Fingers came in contact 
with a globular body just at the orifice that I mistook for 
the unruptured membranes, but by the pressure receded 
and I could find no foetal head. I pressed the body back 
still further when there was a discharge of scalding liquid 
on my hand and wrist. Of course I was now convinced 
that it was the bladder I was manipulating. I then con- 
tinued my explorations and found the os well dilated and 
the unruptured membranes, and soon after first position 
\\as made out. But everything stopped, "pains run up her 
back," her imagination run not; gave her full dose chloral 
hydrate and brom. pot., which quieted her for an honr. 
Still no labor pains, and no advancement of the head. 
Suddenly she roused from a doze and declared she was 
going to have a "fit." Immediately gave the chloroform 



208 The Peoria Medical Monthly. 

to a lady attendant and prepared to deliver. Here was the 
distended bladder again blocking up the way, soon emptied 
it. ruptured the membranes, very strong labor j)ains came 
on and by holding the bladder back till the head was down, 
had the satisfaction of delivering her of a very large male 
child within fifteen minutes after she awoke. Placenta 
followed immediately, and considerable hemorrhage, which 
w^as checked by a dash of cold water on^the abdomen, and 
by grasping the fundus, holding firmly for a few minutes. 
No more bad symptoms, and in an hour was in a quiet sleep. 
On inquiry regarding the bladder, learned that it had been 
that way from the time of her eighth labor, w^hen she had 
her first convulsions. Since that time it had been hanging 
in the vagina and at times she said it w^ould come outside 
and she was compelled to push it back, and most of the 
time had to resort to the process in order to evacuate it. 
She made a rapid recovery and soon after left my field of 
labor, but I learned the bladder difficulty was no worse. 

It may be asked why I did not use forcips. I '^as fully 
prepared to do so, but as nature had plenty of room, 1 pre- 
ferred to give time in the first stage, after that when con- 
vulsions seemed eminent I had no time. 

Query. Did the condition the bladder was in have 
any connection with the convulsions in the three labors 
preceding this? 



Art. IV.— Uterine Tonics. By A. H. Kinneak, M. D., Metamora, Illinois. 

Time was when many diseases that flesh is heir to 
were generally attributed to a torpid liver and the first 
thing in order was to regulate said viscus and all would be 
right, but, the poor liver has had its day and the physician's 
attention is now called to search in other fields for the 
hidden trouble and when found proclaims to the world 
that the secret has been discovered and there is no need of 
further trouble or worry, and here rests, all further investi 
gation would be useless, and his labors, no matter how 
faithful he might be, would be fruitless 



Our Clinical Society. 209 

Such may have been the case in the past in the theory 
and practice of medicine, but certainly is not what we 
observe at the present time for the causes and their reme- 
dies are nearly as numerious as the sands of the sea, each 
having its advocate, and to increase its perplexity new ones 
are constantly being added, and were we deprived of the 
privilege of reading our medical periodicals many of them, 
w^ould never reach the notice of the general practitioner, 
and some of which it would have been a blessing if they 
had never been brought to light. But we have to test all, 
and in this way we soon learn the virtues of each and 
select for our use those which prove to be the most potent 
to restore to health those so unfortunate as to be stricken 
down with the many diseases man is subject to. The 
physician whose mind is well versed in the multiplicity 
of remedies we have to treat disease with is qualified and 
entitled to the respect and confidence of his fellowmen. 

Some two years ago my attention was called to the 
virtues of caulocorea as a uterine tonic, with the request 
to give it a trial. I will state that I have given it a fair 
trial and find that it has proven in my hands what it was 
recommended to do by the firm who prepare it, (Ur J. W. 
Lowell & Co., Portland, Me.) in the cases in which I have 
tested it. 

Given in connection with the local treatment in ulcer- 
ation of the OS, and cervical endometritis, also in hyper- 
tropy and the various lencorrhOeal discharges, I find that 
it gives greater aid than any class of tonics that are 
usually prescribed in such cases that I have tried. It has 
also given good results in amenorrhoea and menorrhoea. In 
the two latter its effects are similar to the old lady's silk 
dress, viz: warm in winter and cool in summer, 

I would recommend a trial of it by physicians who 
give particular attention to the treatment of female dis- 
eases and believe they will be rewarded in their effort, and 
that they will find that it relieves pain and nervousness 
more readily than is reached by other remedies. 



210 The Peoria Medical Monthly. 

Art. v.— Tape Worm. By A. E. Rodgers, M. D., El Paso, Texas. 

It is with pleasure that I have noticed in the Monthly, 
and also other medical journals, the discussion of the treat- 
ment of tape worm. Allow me to add my mite. In this 
part of the country we find a gi-eat many cases of tape 
worm," and for some time in my early practice I was quite 
unsuccessful in my treatment of such cases, but since 
following my present course of treatment my success has 
been surprising even to myself. 

I do not starve my patient; commence by ordering a 
full dose of castor oil upon going to bed, followed in the 
morning with the following: 

Olfi resinte felix mass, 2 drachm.s. 

Olei. terebinth., 1 drachm. 

Ext. pepo, fl. q. s. 2 ounces. 

M. Sig. Teaspoonful every fifteen minutes. 

The worm is generally expelled whole after taking 
about the third dose. My objection to the above is that it 
is hard tor some to retain the remedy in tlreir stomach. 



Abt. VI. — Excessive Vomiting of Pregnane}-. By G. O. Bailet, jM. D., Ar- 

miiigton, Illinois. 

I make this clinical report simply to bear testimony to 
what has been often spoken of before as a remedy for 
vomiting of pregnancy: 

January 21, 1884, was called to a neighboring town 
eight miles away to see a Mrs. W., two months gone with 
first pregnancy. She had been troubled ever since the 
third or four week with excessive vomiting. With a very 
weak consumj^tive diathesis, much of this time (6 weeks) 
vomiting up everything she took into her stomach and 
latterly growing worse, until it seemed she did not retain 
anything. She was truly a pitiable case in appearance as 
well as in her own mind. I gave her most of the usual 
remedies in such cases: Bis. sub. nit. oxalate, ceri. peps, 
ae. hydroch, creosot nuix. vom. liq. pot. arsen, etc.; used in- 
jections pr. rectum of warm water and pot. bro. with chlo. 
hyd.; applied ext. bellad to the mouth of the womb and 



Book Notices. 211 

used warm water injections two or three times each day 
into the vagina, all this with very little if any improve- 
ment. She hardly slept any, was almost constantly belch- 
ing or vomiting, not able to retain anything like food, 
water or medicine. January 25, at my third visit I gave 
her h3q3odermic injection of mor. sul. gr. i, sul. atrop. gr.. 
1-60. In fifteen minutes she was asleep, and slept for 
several hours; the first good sound refreshing sleep she had 
enjoyed for many days. After she awoke she was able to 
retain a small quantity of fresh milk with lime water, of 
which we continued to give her a little every two or three 
hours. Being a good way from home and in mid winter, I 
left the syringe with the husband with directions how to 
use it when there were symptoms of the return of vomit- 
ing. This w^as my last visit. He wrote me each day and I 
sent him directions as to diet, etc. He used the syringe 
twice after this, each time giving relief. Some two months 
ago I saw the husband who reported her doing well, 
having had but little trouble since my last visit. They 
have since moved still further away. 

Since this 1 have used a solution of about the same 
strength, pe. orem, in several cases with good effect, though 
not so bad as this case. 



i0oli ilotiais. 



Fifth Annual Report of the State Board of Health of Illinois. 8 vo. paper 
pp. 600. State Printing House, Springfield, 111., 1883. 

This volume contains an amount of labor that is really 
stupendous, and to the x^hysician, sanitarian or statisti- 
cian is simply invaluable. Besides containing reports of 
the various meetings of the Board, which only take up 44 
pages, there is also included the report on Medical Laws 
and Institutions in the United States and Canada, giving 
the medical laws of each state, the standing of every col- 
lege, and an immense quantity of information on the subject 
of medical education that cannot be obtained elsewhere. 



212 The Peoria Medical Monthly. 

This chapter takes up over 200 pages. Then we have a 
history of the small-pox epidemic of 1880-82, which is 
probably the most valuable contribution to the literature 
of this disease made within the past fifty years. It is im- 
possible to even enumerate in this space at our disposal, 
the sub-heads of this chapter, and it must suffice to say, 
that no such complete history of any epidemic, to our 
knowledge, has ever been written. The causes, means 
taken to prevent its spread, cost to the community, vacci- 
nation reports, etc., etc., are carefully set forth in almost 
innumerable tables, and form by no means the least inter- 
esting portion of the volume. The chapter on Immigrant 
Introduction of Small-Pox is valuable to every part of the 
Union. The vaccination of school children under the order 
of the Board probably saved the state thousands of lives 
and millions of money, and under the systematic method 
prescribed affords statistical information^ of very great 
accuracy and value. Mortality statistics of the state and a 
very complete index close the volume. We presume a 
copy can be had on application to the Secretary of the 
State Board of Health, Dr. John H. Ranch, Springfield, 111. 

Malaria and Malarial Diseases. By Geo. M. Sternberg, M. D., F. R. M. S., 

Major and Surgeon U. S. A., etc., etc. Cloth, S vo., pp. 330. Wm. Wood & 
Co., New York, 1884. 

Anything pertaining to the subject ot malarial or 
periodic fevers will be received by the profession with great 
interest, and although the author of the volume before us 
disclaims any originality of investigation, he has given us 
the recorded experience of observers both in our own 
country and in other lands where malarial fevers are en- 
countered by the physician. This work has been satis- 
factorily done and the result is the most complete and 
compact review of the whole range of the subject in the 
English language. The contents of the book are naturally 
divided into two parts: Part first on Malaria — What it is; 
how disseminated; its nature; effects; antidotes; prophy- 
laxis, and geographical distribution, forming interesting 
chapters. 



Book Notices. 213 

Part second, discusses Malarial Diseases, which the 
author divides into three general classes: 1, Malarial in- 
termittent lever including masked intermittents, perni- 
cious and algid pernicious intermittents, congestive inter- 
mittents, etc. 2, Continued malarial fever, comprising the 
simple, ardent, adynamic, pernicious and complicated 
forms of remittent fevers. 3, Hemorrhagic malaral fever, 
including intermittent haematuria and grave malarial 
hsematuria, • 

Sufficient use of the great medical library at Wasliing- 
ton has been made by Dr. Sternberg, and recent periodical 
literature has been carefully perused for the latest writings 
of medical practitioners and investigators. 

Sexual Neurasthenia, ( Nervous Exhaustion). Its hj^giene, causes, symptoms 
and treatment, with a chapter on diet for the nervous, by Geo. M. Beard, 
A. M. M. D., etc., etc. Posthumous manuscript, edited by A. D. Rockwell, 
A. M. M. D., etc. Cloth, pp. 270; price $2.00. E. B. Treat, 757 Broadway, 
New Yorli, publishers. 1884. 

Everything that the late Dr. Beard wrote received 
attention, not only because he was a good writer, but 
because he was a man who had something to write, and 
was deeply in earnest, and this last work of his fertile brain 
will be read with great interest. It is on a subject on 
which much has lately been written, and about which there 
is much yet to learn. Dr. Beard treated it in his usual for- 
cible manner, and wrote a work that we believe is the best 
yet written. We can safely recommend it. 

Students 3Ianual of Electro-Therapeutics. By R. W. Amidon, A. M. M. D., 
etc., etc 12 mo. cloth, pp. 94. G. P. Putnam's Sons, New York. 

This little volume is made up from a course of lectures 
in the Woman's Medical College ot New York, and is too 
small to be of much real value to students or practitioners. 
It is not elementary enough for beginners, and too frag- 
mentary for more advanced students or graduates. The 
author has done himself an injustice in cutting down his 
subject to such an extent. 



214 The Peoria Medical Monthly. 

Proceedings, Addresses and Discussions of the Third 
Semi-Aunual Meeting of the Kentucky State Sanitary- 
Council, held at Bardstown, Ky., March 26-27, 1884, under 
the auspices of the State Board of Health. 8 vo. paper, pp. 
00. Louisville, Ky., 1884. 

Hydronephrosis. An essay based upon the compara- 
tive study of seventy-one cases of that lesion, of which one 
case came under the personal observation of the writer. 
By Geo. A. Staples, A. B., (Harv.) M. D., Dubuque, Iowa. 

Reprinted from the Journal of the American Medical 
Association, April 12 and 19, 1884. pp. 20. 

First Annual Report of the Presbyterian Hospital in 
the city of Chicago, Illinois, with constitution, by-laws and 
charter. Organized and incorporated 1884. 



^muoiH ma l^ftistrart. 



CONDUCTED BY DR. 0. B. WILL, PEORIA, ILL. 

Massage in the Treatment of Stricture of the Urethra. 

The difficulty of passing a sound in stricture of the 
urethra following gonorrhoea depends, in the majority of 
cases, not so much upon the simple narrowing of the 
urethra itself as upon proliferation of the connective tissue 
in the surrounding pai'ts. This hyperplasia of the connec- 
tive tissue occurs in irregular patches about the urethra in 
such a way as to render the canal tortuous, thus increasing 
the difficulty of passing an instrument to the bladder. Dr. 
<reza V. Antal relates a number of cases {Cenfralblatt fur 
C/tinirf/ie, June 7, 1884) in which he succeeded in inducing 
absorption of this hyperplasia by massage. The duration 
of each sitting was from eight to ten minutes, and the mas- 
sage was repeated daily. Massage of the pendulous portion 
of tho urethra presents no difficulties, but that of the 
membranous and prostatic portions is possible only through 
the rectum. Internal massage by means of the repeated 
introduction and withdrawal of a sound, as recommended 
by Bardinet, does not commend itself to the author. It is 



Periscope and Abstract. • 215 

only possible in those cases in which the stricture is 
already permeable, while v. Antal's method is of especial 
value precisely in those cases in which the urethra will 
not admit of the passage of a bouj^ie. Further than this, 
internal massage acts only upon the thin layer of tissue 
immediately surrounding the urethra, while the external 
method causes the entire hyperplasia to disappear. The 
author thinks that in many cases massage will be used in 
preference to urethrotomy. — Medical Record. 



Treatment of Sweating- of the Feet. 

The following method of treatment for this unpleasant 
condition. is endorsed by Dr. G. Cramer in Memorabilien, of 
May 14, 1884. The patient must wash his feet thoroughly 
in a two to five per cent, solution of carbolic acid, at first 
twice a day, then once a day, and finally two or three 
times a week. After the bath he is to put on clean stock- 
ings, sprinkle inside and outside with a powder composed 
ot two parts benzoin, three parts salicylic acid, and ninety- 
five parts magnesia. The shoes must also be sprinkled 
inside with the powder. The stockings, when taken off, 
should be allowed to soak for twelve hours in carbolized 
water, then dipped in iye and washed. In this way the 
bacteria which cause the skin affection and the consequent 
abnormal secretion of sweat are destroyed. Without this 
thorough disinfection. Dr. Cramer maintains, a cure of the 
affection is impossible. — Medical Record. 



Pudendal Hematocele. 



We make the following synopsis of the treatment of 
pudendal hematocele, as recommended by .Dr. Fruitnight 
in an article on that subject in the American Journal of 
Obstetrics: 

Never incise a recently-formed effusion of blood, lest 
uncontrolable and fatal hemorrhage ensue. When seen 
early arrest hemorrhage by application of cold and pres- 
sure. Small effusions may be absorbed or encysted; only 
keep patient quiet and apply evaporating lotions with 
pressure. Opium may be given to relieve pain. 

When effusion is large it will be necessary to incise 
tumor at sometime in its history. Suppuration may bring 
sepsis. Clear out the clots, wash out the resulting cavity, 
and make use of the iodoform and firm pressure. If bleed- 



216 The Peoria Medical Monthly. 

ing continues unreasonably long use ligatun for bleeding 
vessels. If labor be impeded by effusion at the time, make 
free incision at most dependent part. If it occurs before 
presenting part has descended, pressure must be applied. 
Do not remove all clots at first; those which seem to adhere 
will come away with subsequent dressings. Incision should 
be free. Secure free drainage at all times. It is preferable 
to cut on vaginal side of labiam majus. 

If effusion is small and no absorption after reasonable 
time, encourage suppuration by hot poultices and liberate 
pus as soon as pointing takes place. Frequently irrigate 
cavity with disinfectant lotions, preferably bichloride of 
mercury, 1 part to 2,000, or of phenic acid of a two per 
cent strength. 



The Diag-nostic Value of Certain Syniptoiiis in the Diseases of 

Children. 

Professor S. M. Politzer formulates the following con- 
cerning the significance of individual symptoms in children's 
diseases {Deutsche Medici ual-Zeitung, May 19, 1884) : 1. 
The symptom of a strongly-marked nasal tone in crying 
points to the probable existence of a retropharyngeal 
abscess. 2. A loud and very long-continued expiratory 
sound with normal inspiration and the absence of dyspnoea, 
is significant of chorea major. Sometimes this sound 
resembles the bellowing of an animal, and may continue 
for a long time as the only symptom for chorea. 3. A 
thoracic, sighing inspiration indicates cardiac weakness. 
This is one of the first symptoms, appearing before cyanosis 
or pallor of the face, thready pulse, coldness of the extrem- 
ities, or the other well-recognized signs of weak heart. 

4. A marked diaphragmatic expiration, accompanied with 
a fine, high-pitched whistling, points to bronchial asthma. 

5. A marked interval between the end of expiration and 
the beginning of inspiration renders the diagnosis of 
catarrhal laryngitis without exudation probable. 6. There 
is no special significance in the loud, sort of bleating, 
expiratory sound som-etimes observed in infants during the 
first month of life. It seems to depend upon a modified 
innervation within physiological limits, and resembles the 
want of rhythm in the cardiac movements occasionally met 
within the early years of childhood. The following symp- 
toms are given by the author as of value in the early 
diagnosis of cerebral diseases: 1. A peculiar drowsiness, 



Periscope and Abstract. 217 

continuing for several days, unaccompanied by fever or 
other disturbance, is indicative of basilar meningitis. This 
is a more valuable sign than headache, vomiting, or a slow, 
irregular pulse, since the latter may occur in various 
extracranial diseases. 2. A tense, elevated anterior fon- 
tanelle points to intracranial effusion. If it be very 
prominent, resistant to pressure, and without a sign of 
pulsation, there is almost certainly an intermeningeal 
hemorrhage. A deeply-sunken fontanelle indicates inan- 
ition and a diminished volume of blood. 3 Very slow 
movements of the eye, followed by fixity in one position, 
a vacant stare, and a peculiar lazy closing of the lids are 
signs of a beginning basilar meningitis. The character of 
the cry is of value sometimes in the diagnosis. 1. A fit of 
shrill crying, lasting for two or three minutes, accompanied 
by an expression of fear in the face, and coming on regu- 
larly an hour or an hour and a half after the child has 
gone to sleep, it is the expression of night-terrors. Quinine, 
given in rather large dose one or two hours before bed-time, 
is an effectual remedy against this trouble. 2. Periodical 
crying-spells, of five or ten minutes' duration, coming on 
sometimes during the day, but more frequently only at 
night, points to cramps in the bladder, provided that we 
can exclude intestinal or gastric colic. This is speedily 
cured by emulsion of lycopodium with or without bella- 
donna. 3. Crying while at stool and an evident dread of 
the act of defecation are signs pointing to fissure of the 
anus. 4. Hard, continuous crying, expressive of severe 
pain, together with frequent putting of the hands to the 
head or rolling of the head in the pillow, are evidences of 
otitis media or pain in the ear from some other cause. 5. 
When for days and weeks the child cries on being moved, 
and when there is also profuse sweating and an elevated 
temperature, the disease is rickets. 6. Frequent crying, 
with habitual sleepiness during the first two years of life, 
are found in anaemic and poorly-nourished children, or in 
those with congenital syphilis. Finally, Professor Politzer 
recounts some other single symptoms which aid in forming 
a speedy diagnosis. 1. The peculiar physiognomy of child- 
ren suffering from congenital syphilis. The sinking in of 
the root of the nose, the sallow complexion, the scanty 
eyelashes, the yellowish edges of the eyelids, and the 
rhagades on the underlip are characteristic of hereditary 
syphilis. 2. A falling together of the alse nasi, and an 
absence of all motion in them during inspiration, point to 
hypertrophy of the tonsils. 3. A weakness and loss of 



218 The Peoria Medical Monthly. 

motion out of all proportion to the gravity or duration of 
the accompanyino- iUness should raise a suspicion of infan- 
tile paralysis. 4. A partial loss of hearing after a sickness 
is often due to a circumscribed meningitis at the base of 
the fourth ventricle. 5. Depression of the mental faculties 
occuriug after a severe infectious disease is frequently 
indicative of a beginning acquired idiocy. Strychnine 
exerts a favorable influence in these cases. 6. Retarded 
ossification of the skull may imply rachitis. 7. A stiff 
carriage of children in walking, standing, sitting down, 
or stooping, is observed in commencing Pott's disease. In 
children who do not walk there is a painful contraction of 
■the features when they are lifted up or set down. 8. 
Constant vomiting of all ingesta, lasting for several weeks, 
in children with large heads but closed fontanelles, is a 
sign that an acute hydrocephalus is engrafted upon the 
chronic condition. — Medical Record. 



Catheters and Self-Catheterisni. 

Dr. J. B. Mitchell, in the Medical Press, gives the 
results of two years' personal experience upon the subject. 
He dismisses the silver catheter of old times with but few 
words, the so-called gum elastic catheter with the wire 
stylet he considers may still be preferred in some cases by 
the practitioners, but in respect of cas.es wherein self- 
catheterism is practiced, the utility of that kind of instru- 
ment has entirely passed away. About a score of years ago, 
there came into notice a gum catheter without stylet, the 
surmounting of certain difficnlties in the urethal passage 
being secured by means of a permanent bend implanted in 
the instrument (otherwise quite straight) at a short distance 
from the point. The best known of such catheters is the 
condee, so-called from the French word signifying elbowed 
or bent. It has the fewest inconveniences for self-cathete- 
rism, the manipulation required for its introduction into 
the bladder being slight and easily acquired. When irrita- 
tion arises, that accident may be due to one or other of the 
following circumstances, or in some measure to all of them: 
(1) 'i'he condee, by the elbow room which it requires, gives 
rise to an increase of friction in its passage; (2) the eye of 
even the best made gum catheter presents edges calculated 
to ruffle the delicate mucous lining of the urethra, forced 
as it is at the constricted part, to dip into the hollow of the 
eye; (3) the "gum" material, which is dried linseed oil, 



Periscope and Abstract. 219 

being Very readily acted upon by the oily and greasy 
lubricant wherewith the catheter, on being used, is smeared, 
after a certain amount of use, becomes sticky, thereby 
greatly adding to the friction. 

Recognition of these inconveniences has led to the 
manufacture of catheters of mineralized India rubber. 
These instruments, which are extremely flexible, require no 
skilled manipulation; being quite straight there is no point 
of increased friction; the eye is hollowed out and the edges 
so smoothed down as to give rise to no ruflling whatever. 
(This is true, perhaps, of the English instrument only, the 
French India rubber catheter, for instance, being extremely 
defective — dangerously so in the eye). Resisting much 
better than "gum" the action of oil or grease, India rubber 
is much less liable to become sticky. 

Dr. Mitchell here criticises the American catheter as 
furnished by Tiemann, by declaring that its fine polish 
deteriorates after being used a few times, either owing to 
the perishable nature of the rubber, or the effect of the 
London atmosphere upon it, and the substance of the 
catheter becomes brittle. 

Within the last twelve months there has been brought 
out a gum instrument which may be looked. upon as an 
imitation, in boiled linseed oil, of the India rubber catheter. 
It is straight throughout, and very nearly as pliable as that 
instrument. In two respects it certainly compares disad- 
vantageously with the rubber catheter. The margin of the 
eye is not rounded off in such a w^ay as to present no edge 
whatever togive rise to friction, while the material is very 
liable to deterioration from grease. The stickiness which 
results from this deterioration cannot be correctly esti- 
mated by the fingers. Being developed by heat and 
moisture, it rapidly shows itself, however, in the urethra, 
becoming more and more apparent, within certain limits, 
the longer the catheter remains in the passage with the 
obvious result, which in some cases is very marked, of 
causing the withdrawal of the instrument to be attended 
with greater resistance than its introduction. There have 
been cases, indeed, wherein very great effort was needed to 
withdraw a gum catheter which had been passed down the 
urethra with comparative ease. It is very obvious that 
such an amount of dra^gging of the sensitive mucous lining 
of the constricted utheral canal must be productive of 
irritation with more or less of consecutive mischief. 

To keep a catheter smooth and free from stickiness, 
some lubricant must be used that could be easily acted upon 



220 The Peoria Medical Monthly. 

by a solvent incapable of attacking India rubber. . Castor 
oil proved a very superior lubricant, but when submitted 
to the action of alcohol it was only partially removed from 
the catheter. Absolute alcohol would remove it, but was 
expensive and not easily obtained. Sulphuric ether was 
expensive and attacked th< rubber. Pyroxytic ether picks 
up castor oil in a surprisii) : manner. After exposure to its 
action for an hour or tv o in a tube, an India rubber 
catheter, smeared inside as well as outside with castor oil, 
on being withdrawn and then dried, was found to be as 
clean and smooth as it was before use. 

The consistency of castor oil allows of a large measure 
ot extra lubrication. When a certain quantity was, by 
exhaustion at the superior orifice of the catheter, sucked 
into the tube of the instrument, it did not at once seek to 
escape, but kept its place till the constricted part of the 
urethra was reached; here pressure of a stripping character 
exerted between the finger and thumb, in a downward or 
inward direction, upon the extruding upper end of the 
instrument, by expelling the oil wherewith its opposite^ 
end was charged, flooded the urethra with lubricant at the 
constricted part, and bore along as it were, the catheter 
point through the prostatic rapids, landing it safely in the 
bladder. Sulisequent experience has abundantly shown 
that the flooding, when copious, is always completely 
eftectual in the shooting of the utheral narrows. — Journal 
American Medical Association. 



Pressure in the Treatment of Suppurating Buboes. 

Prof. 0. Peterson treats buboes, after fluctuation is 
clearly determined, as follows: A large incision is made, 
and the cavity of the abscess is cleaned out with a large 
spoon. The bleeding is stopped, and iodoform powder is 
applied. Then comes the pressure bandage, which is the 
important factor of the treatment. Its application is as 
follows: First, a ball or wad of salicylic cotton, or other 
soft material made antiseptic by salicylic acid, is formed 
the size of the cavity and placed over it; upon this wad are 
placed several layers of the same material; then a second 
ball or wad, made of tow or oakum, and about four times 
a.s large as the first, is placed on this; over this, oilskin or 
wax paper, and the whole firmly fixed with a gauze or 
elastic bandage. This bandage^ remains untouched for 
from seven to ten days. The average length of healing, in 



I 



Periscope and Abstract. 221 

a trial of three years of this method, was twenty-three 
days; previously the average was seventy to ninety days. 
Twenty per cent, of the cases healed under one bandage, 
twenty- five under two, and twenty under three; more than 
seven bandages were in no case necessary. The average 
number of bandages was two. — -{Centra Iblatt f. Chinirgie, 
November, 1883; quoted in Practitioner, April, 1884.) 



A New Mode of Burial. 



At a recent general assembly of the cement manu- 
facturers at Berlin, says the Lancet, Dr. Fruhling describes 
a new application of cement. He explained that it would 
be easy to transform corpses into stone mummies by the 
use of Portland cement, that substance, when hardened, 
not in anyway indicating the organic changes going on 
within it. He further illustrated the subject by describing 
various industrial uses of lime as a preventive of decom- 
position. The cement, in hardening, takes an accurate 
cast of the featifres which it encloses, thus allowing of 
their exact reproduction after the lapse of centuries. It is* 
suggested to use coffins of rectangular shape, it being 
turther considered by Dr. Fruhling that underground 
sepulture is needless, as the coffins soon become practically 
masses of stone, and can therefore be built into pyramids. 
— American Practitioner. 



Incidents in tlie Life of a Distinguished Doctor. 

In a memorial sketch contributed to the New York 
Medical Journal, by Dr. W. Gill Wylie, on the life and 
works of the late Doctor J. Marion Sims, many interesting 
facts and incidents in his life are given. We omit w^hat 
the writer says of Doctor Sims', professional work, and 
confine our extracts to the biographer's testimonial of his 
deceased triend's personal habits and methods, which carry 
with them good example for others to follow: 

"He was truly master of himself. Vices he had none, 
not even of the smallest kind. The animal in him was 
completely under control. His habits and his appetites 
were always guided by his reason. I ha,ve known him, day 
after day, and month after month, rise at seven, take a 
simple breakfast, consisting of a glass of milk and southern 
hominy, bread and butter, and sometimes an egg. At eight 
enter his carriage and make a few morning calls on severe 



222 The Peoria Medical Monthly. 

cases. At nine return to his office and see patients till one 
or one thirty, and take a simple lunch of steak, potatoes, 
etc. At two enter his carriage, visit patients, operate, etc., 
returning home usualh" about five or six, write letters, and 
at seven take a plain dinner of one- kind of meat and vege- 
tables. He never took wine, nor coffee, nor tea, nor condi- 
ments of any kind. At the table he was usually talkative 
and playful, talking about the topics of the day, the 
theatre, of which he was very fond, etc. After dinner he 
usually wrote letters and did light work, reading journals, 
etc., or passed his time with his family or friends in the 
drawing room. About nine thirty he would usually go to 
his bedroom, where he read or wrote, sometimes lying in 
bed until midnight, when he would retire for the night. 
It was always marvelous to see him so continuously and 
persistently intent upon his work. He had a habit of writ- 
ing down ideas at night, by means of a pamphlet, the edge 
being placed on paper so as to guide his pencil without 
a light. 

"When one was familiar with his capacity for endur- 
ance, his power for concentration, his unbounded enthu- 
siasm, his deliberate persistent painstaking work, backed 
up by his unselfishness and undaunted moral courage, it 
was not surprising to witness his success. His motto as a 
boy was, 'Duty before pleasure.' Later in life he needed 
no motto; it had become a habit for him to do what he 
thought was right. Difficulties, obstacles, and trouble were 
as nothing to him when once he had made up his mind to 
act. He went directly at a thing, and he kept at it until 
it was mastered. It was this great painstaking and per- 
sistent work that made things so clear and so definite to 
him, and enabled him to express his ideas so lucidly. It 
was also this power that developed his self-reliance and his 
moral courage, and made his instruments and his methods 
of operating so near perfect that those who claim to im- 
prove or modify them, are merely working backward over 
the same ground that Marion Sims traveled over. in per- 
fecting them. His was the inductive method, or working 
and perfecting method — a developing method. He cleared 
away complications, and gradually simplified ideas and 
instruments, till they approximated the truth and the best. 

"He was no idle dreamer; he never wandered into 
intangible mysticism: there was neither confusion about 
his work, nor indetiniteness about his aims. 

"His mind was always aggressive, progressive, recep- 
tive and ingenious. He was a leader — a j^ractical genmsr 



Periscope and Abstract. 223 

The Mortality of Married Iiife. 

The Journal of the American Medical Association cites 
some rather remarkable statements from an address de- 
livered by Dr. William Pratt, of London, as follows: 

"According to statistics the married life is not only the 
purer, producing the minimum of evil-doers and criminals, 
but it has also by far the most health. Take the male sex, 
and it is seen that from twenty-five to thirty years of age 
one thousand married men furnish six deaths; one thousand 
bachelors furnish ten deaths; one thousand widowers fur- 
nish twenty-two deaths. The figures, however, become 
very unfavorable it the marriage be contracted before 
twenty. Out of eight thousand young men married before 
twenty their mortality has been found to be, before mar- 
riage, only seven per one thousand; after marriage, fifty 
per one thousand. With respect to the female sex we find 
a similar advantage of marriage over celibacy, but on the 
same condition. If young girls be turned into wives betore 
twenty a like mortality befalls them which befalls the 
other sex. Everywhere young married people from eigh- 
teen to twenty years of age die as fast as old people from 
sixty to seventy years of age. The common sense and 
common law of Western Europe have with perfect justice 
marked twenty-one as the age of maturity. After that 
epoch, however, marriage should be contracted as soon as 
practicable. It is the healthiest and the happiest life; the 
best for the individual and the community." — Boston Medi- 
cal and Surgical Journal. 



Oral Hygiene in the New Born. 

The author remarks the importance of this subject 
from the fact that the mouths of children are susceptible 
not only to ordinary affections which are common to all 
ages, but also to certain others which are restricted to the 
early period of life. Since these affections can in most in- 
stances be avoided, the importance of attention to this sub- 
ject is quite evident. The diseases to which the author 
calls attention are simple erythema, catarrhal stomatitis, 
circumscribed necrosis of the edges of the palate, and other 
similar changes at other points in the oral mucous mem- 
brane, and thrush. The exciting causes of catarrh may be 
referred to the irritating action of air, food, the act of swal- 
lowing, etc., upon a very tender surface. It may be merely 
a local phenomenon, a symptom of an affection which in- 



224 The Peoria Medical Monthly. 

volves the iiiucoiis membrane of the whole intestinal tract, 
or it may be an accompaniment of a general disease: With 
the catarrh may be associated a softening and destruction 
of the epithelium upon the postero-lateral portions of the 
hard palate, which may develop into an infiltration and 
necrosis of the mucous membrane throughout its entire 
thickness, in the larger or smaller patches known as 
aphtha?. Other portions of the hard palate, the soft palate, 
and the dorsal surface ot the tongue along its central por- 
tion are less frequently affected. Innocent as this disease 
is in some cases, in otheis it leads to quite serious con- 
ditions, which may affect the entire organism. Such con- 
ditions in the shape of pain and interference with sucking, 
very soon tell disastrously upon the sensitive constitution 
of a new-born infant. Dyspepsia intervenes, and with it 
may come gastro-enteritis, inflammation of the salivary 
glands and their ducts, nasal catarrh of a muco-purulent 
character, purulent inflammation ot the middle ear, bronchi- 
tis, or labor pneumonia. The local trouble maj^ assume a 
phlegmonous form, with ulceration or gangrene of the 
mucous membrane at various points, which may be com- 
plicated by the formation of abscesses in the alveolar bor- 
ders or on the floor of the mouth, deep ulcerations in the 
fraenum of the tongue, purulent glossitis, retropharyngeal 
abscesses, and erysipelas. The most frequent cause of 
the beginning of all these troubles is the mechanical irri- 
tation of a very tender surface, and the common habit of 
washing out the child's mouth immediately after nursing, 
for the purpose of removing the milk adherent to the 
mucous membrane. This procedure, by rubbing off the 
epithelium, and even producing slight hemorrhage, often 
begets the very condition it is designed to prevent. Mention 
is made of the irritation which may be produced by a 
physician in removeing the mucous from the mouth of a 
new-born babe, or by the nurse introducing her finger into 
its mouth for whatever cause. The author infers that the 
true treatment is prophylactic — no interference with the 
condition of the mouth until there is plain indication for 
it. Among three hundred infants seen by him at the 
Foundling Hospital at Prague, within a period of eight 
weeks, one hundred were from Briesky's clinic, in which 
non-interference with the mouth is the rule, and in only 
fifteen were there affections of the mouth. In the remain- 
ing two hundred, one hundred and thirty-three had some 
form of disease of the mouth. — Epstein, Arch. f. Kinderk, 
b. v., h., 7 and 8. — Archives of Pediatrics. 



Periscope and Abstract. 225 

Iodide of Potassium in Pneiiniouia. 

Regarding pneumonia as a general disease with local 
nianifestations, Dr Schwarz recommended the use of iodide 
of potassium in six grain doses every two hours, at the 
same time applying an ice-bag to the chest over the seat 
of the pulmonary lesion. All his cases thus treated 
recovered, some of them within two days. Dr. Gualdi 
{Gazetta Medica di Roma, May 15, 1884) has similarly 
treated a number of cases, and reports most excellent 
results. He formulates the following conclusions based 
upon his experience with this mode of treatment: 

1. Schwarz's method of treating pneumonia gives 
good results. 

2. These results are even better in the case of children 
than in that of adults. 

3. The treatment should be instituted at the begin- 
ning of the disease, for when commenced at a later stage 
the cure is less rapid and satisfactory. 

4. The action of the iodide is exerted upon the fever 
and the general disease, and not upon the local lesion 

5. The iodide and the potassium become separated 
within the organism and each of them exerts a special 
effect. 

6. The action of the ice is upon the local condition. 
It is useful in the period of pulmonary congestion, but 
injurious in the stage of hepatization. — Medical Record, 



Membranous and Laryngeal Diphtheria. 

It is impossible to draw any valid distinction between 
membranous croup and laryngeal diphtheria, because none 
such exists. Diphtheria may originate in any part of the 
pharyngeal, nasal, or laryngeal tract and extend to any 
other, theoretically at least, for though the laryngeal 
affection rarely if ever does so extend, it is simply because 
for anatomical reasons any serious amount of such diph- 
theria is fatal before it has time to spread, unless it end in 
speedy recovery, in which case it of course does not go 
beyond its original seat. But why should we persist in 
restricting the term diphtheria to those cases in which the 
fibrinous exudation is conspicuous and highly developed? 
We do not act thus with other specific diseases. We are 
all familiar with cases of scarlatina in which there is no 
rash and the nature of which is not recognized until 
symtoms of kidney mischief, of dropsy or uremia, manifest 



226 The Peoria Medical Monthly. 

themselves, or the nature of the tirst cases which perhaps 
recovered without any sequelae is disclosed by their having 
given rise by infection to others of typical and unmis- 
takable scarlatina. As Dr. Parsons remarked, whenever 
scarhitina is epidemic there are to be seen numbers of 
persons with flannels round their necks who do not suspect 
that they have anything more than a common sore throat, 
the result of a "cold." And so it is with diphtheria, of 
which the membrane is but a fully developed stage of the 
exudation which, like tlie rash ot scarlatina, is a symptom, 
not the essence of the disease — a symptom which may 
exist in any degree or be so imperfectly manifested as to 
escape recognition altogether. 

This imperfect development is indeed more likely 
to occur in diphtheria, since it is not so highly differ- 
entiated, not so specialized a disease as scarlatina. It is 
essentially a lilth disease, and, as is probablj'^ the case with 
enteric fever, ma}^ be generated de nova though not de nihilo. 
When once called into existence, however, it is propagated 
by ordinary infection, whether through the vehicles of air, 
or water, or by personal contact, or by fomites. The same 
w4de variation in its characters attaches to enteric fever 
which may be marked merely by looseness of the bowels, 
weakness, and malaise. Indeed it may be said that these 
diseases vary in more than degree, and pass by insensible 
gradations into non-specific affections of the pharynx and 
interstine respectively. As to the relation between diph- 
theria and scarlatina it is difficult to believe that any true 
connection exists. — London Medical Times. 



The Treatment of Scalj) Wounds. 

We hail with pleasure the suggestion made by a cor- 
respondent of the Lancet, which, while not very new, is 
yet worthy of repetition: 

The scalp is remarkable for the looseness with which 
it is attached to the subjacent bone, and in simple cuts 
through the scalp, blood and serum can readily force a way 
between the scalp and the bone, and the accumulation 
induce suppuration. Still more frequently the scalp is 
torn away from the scull in a longer or shorter flap, and 
then, if the edgos of the wound are united, the serum 
effused from the under surface of the detached flap is con- 
fined beneath it. and suppuration occurs. If this fact be 
neglected, suturing scalp wounds is a dangerous step; but 



Periscope and Abstract. 227 

if it be recognized and acted upon, the sutures are alto- 
gether devoid of danger. The main thing in the treatment 
of any flap scalp wound, however slight the flap may be, 
is to secure primary adhesion of the flap to the subjacent 
pericranium and completely prevent accumulation of serum 
beneath it. This must be secured by properly adjusted 
pressure ; and, in view of this primary indication, but 
secondary importance should be attached to the rapid 
healing of the edges of the wound. If a good bunch of 
hair to taken up on each side of the wound and twisted, 
and then used as a suture, it is obvious that the whole 
surface of the scalp from which the hair springs is held 
compressed against the subjacent skull, and hence this form 
of suture skilfully employed really fulfils the indications 
of treatment very well. It is an error to suppose that the 
tissue of the scalp is more intolerant of the presence of a 
suture than the skin of any other part of the body. 
Cin. Lancet and Clinic. 



Vinegar in Post-Partuin Hemorrhage. 

Dr. Griggs relates in the British Medical Journal the 
case of a "flooder" in whom a profuse hemorrhage was 
almost instantaneously arrested by the administration of 
vinegar. The uterus, which was flaccid and gradually 
dilating, contracted at once after the patient had been 
given a wine glassful of vinegar, and after the second dose 
of the acid the hemorrhage ceased entirely. He states that 
the pupil midwives are accustomed to give this remedy in 
preference to ergot, as its action is more rapid and certain. 
So rapid, mdeed, he asserts, is its action, that he counsels 
against its use until after the expulsion of the placenta, for 
fear of causing a retention of that body. 



Remedy for Rhus Poisoning-. 

As this is the season when many persons are making 
excursions into the country, it is to be expected that there 
will be many who will sufter from poison contracted by 
contact with the poison oak. Various remedies have been 
employed to relieve the sulfering thus occasioned, but while 
one remedy is advantageous to some persons it utterly fails 
with others. Having learned of a great numbei of cases 
in which the fluid extract of serpentana has been used with 
remarkable success, I thould it would be well to communi 



228 The Peoria Medical Monthly, 

cate the fact to your journal, as I have never seen it 
noticed in medical or pharmaceutical journals. It is best 
applied by placing cloths moistened with the extract upon 
the affected parts, without any friction. Two or three 
applications generally affect a cure. — T. S. Wiegand in 
American Journal of Pharmacy. 



Nitrite of Aniyl. 



Permit me to offer the following therapeutic observa- 
tions on the modus operandi Qf the nitrite of amyl, which 
has proved itself to be in my experience a valuable agent 
in a certain class of affections which the general practi- 
tioner is very apt to be called upon to treat in his daily 
routine of professional duties. The highly valuable 
researches by various investigators have called the par- 
ticular attention of the profession to its therapeutic value 
and fully demonstrated the true physiological action of the 
nitrite of amyl. 

In angina pectoris I have seen almost specific power 
from the use of the drug. In most cases of true angina 
pectoris there is organic disease of the walls or of the 
valves or of the coronary vessels of the heart, and it seems 
highly probable that the pain in this affection is unques- 
tionably due to these organic changes in the heart itself, 
than that it is a secondary result of a peripheral arterial 
contraction occurring without obvious exciting cause. My 
own explanation of the relationship between the pain of 
true angina pectoris and the arterial contraction is that 
the high arterial tension is a secondary reflex action and 
not the primary cause of the cardiac agony, and in addi- 
tion to the centripetal nervous influence which produces 
the pain, there is an influence reflected from the nervous 
centre through the vaso-motor nerves, and thus exciting a 
more or less general contraction of the arterioles. It is 
yery probable that the peripheriil arterial resistance, 
although not the primary or the main cause of the pain, 
yet adds to the distress and the danger of the paroxysm. 

The manner in which the nitrite of amyl affords the 
desired relief which it often does is not without practical 
utility, morf3 osp(3cially as a guide in the selection of cases 
which are suita})le for the employment of the drug. I 
generally commence by giving an inhalation of three drops 
on a handkerchief to the nose and then to gradually 
increase yro re vata as soon as the face flushes or the heart 



Periscope and Abstract. 229 

becomes excited, then a short intermission between several 
minutes should be observed, for during that time the effects 
always increase, even if no more be inhaled. The result of 
my first trial of three drops in a case was truly wonderful. 
The patient was in a very serious paroxysm, and as soon as 
the inhalation was tried it was aborted (so to speak) in 
about two minutes, whereas heretofore under other reme- 
dies the length of time was about twenty minutes; and 
after a time the frequency of the paroxysm was notably 
diminished, and under these improved circumstances 
finally ceased. The flushing of the face forbids the con- 
clusion that the cause of the cardiac distress was due to a 
general contraction of the arterioles, and that the relief 
was due to the relaxation of the arterioles. 

I have used it in connection with relieving neuralgic 
pains, which it does very rapidly. 

A case a few weeks ago of severe facial neuralgia, 
which had resisted various remedies, came under my pro- 
fessional observation. I gave her five drops of the amyl on 
a handkerchief, and in a few minutes the pain was com- 
pletely relieved. In a few hours it returned, although in a 
milder form, which was again effectually removed by the 
inhalation of the amyl, and, after several repetitions of the 
dose, the cure was complete. I have also used it in similar 
doses by inhalation with immediate results in asthma, in 
spasmodic dysmenorrhea, and also in epileptic paroxysms, 
where there is a marked epileptic stasis, and where the 
patient passes from one convulsion into another. In 
hysteria convulsions it acts to a charm; in fact, the drug 
itself seems to act with specific power in three classes of 
cases. — D. C. J. Fox in New England Medical Monthly. 



Watch for Accicleuts. 



Dr. Goodale in a lecture at the university hospital pub- 
lished in the Medical and Surgical Eeporter, relates the fol- 
lowing to put physicians on their guard: 

"A number of years ago I was called to assist a physi- 
cian who had a large obstetric experience. He had become 
completely demoralized over a tedious labor. He had put 
the forceps on and had got through the worst of it when 
he gave out and had- to send for my assistance. I then 
took hold, and after bringing the head down to the peri- 
neum, handed the forceps to the physician to complete the 
labor, so as not to take the wind out of his sails. He at 
once turned the head out, and I felt sure than something 



230 The Peoria Medical Monthly. 

must have given v^ay. After the placenta was delivered, 
he went to wash his hands, and while he was doing so, I 
took the opportunity of examiuini?, and found the perineum 
torn down to the rectum. I asked him to examine the 
parts. He put his finger in the vagina, and said: ''Oh, 
yes! the placenta has been taken away; everything is 
right." I then called his attention to the rupture of the 
perineum, and a look of blank astonishment came over his 
face. Neither of us had a needle, so we borrowed a darn- 
ing needle and sewed up the parts with stout linen thread. 
The union was perfect. 1 have seen the same thing happen 
in other cases to which I had been called, and, in my 
younger days I have done it mj^self." 



Rectal Etherization. 

The above new method of curing anesthesia seems to 
be rapidh' falling into disrepute. First one occurrence and 
then another in connection with its use serve to throw 
doubts upon its utility in most cases. "The period of 
excitement which was supposed was not experienced 
appears, however, to be present in many cases." Diarrhoea 
occurs in many instances, sometimes with bloody dischar- 
ges, and it is found that great uncertainty exists in every 
instance as to the quantity of the anesthetic actually re- 
ceived by the patient, for the reason that rapidity of ab- 
sorption varies with the condition of the rectum, and the 
distention of the latter with the vapor constitutes a maga- 
zine of quite uncertain power. 



Treatment of Condylomata. 

Salicylic acid and boracic acid are both very good 
remedies in syphilitic condylomata. Formerly we often 
used to remove larger warts of that kind with the scissors, 
and then cauterized the wound; but since we have been 
employing the following p;)wder, which is dusted three 
times daily over the new r f)wth, we have never had occa- 
sion to have recourse to ai / other remedy: 

Hydrarf,'. muriat. niit., 30 grains. 

Acid, boracic, 15 grains. 

Acid salicylic, 5 grains. 
M. F. pulv. 

All moisture and disagreeable odor at once ceases, and 
who has not seen the effect of this powder, would scarcely 
believe it. The condylomata almost visibly dwindle away. 
— Medical and Surgical Reporter. 



Periscope and Abstract. 231 

* Irritable Heart.— Hypochondriasis. 

The folio wiug is an extract from a clinical lecture by 
Roberts Bartholow, in the Col. and Clin. Record: 

Gentlemen: — The first case presented this morning is 
intended to illustrate the action of a remedy. This young 
man, of a nervous type of constitution, has suffered from 
an extremely irritable state of the heart. It is purely a 
nervous condition, and due to diminution of the inhibitory 
influence normally exerted upon the heart. The number 
ot pulsations is increased, and the area of the impulse en- 
larged. There is no hypertrophy of the heart. When he 
lies upon the left side, the impulse of the organ against the 
bed is so strongly transmitted to the ear that his position 
is unbearable. He comes for relief from this condition of 
the heart. 

To relieve him, we may use remedies to diminish the 
motor activity of the heart, to lessen the irritability of the 
accelerator apparatus or increase the inhibition. I have, 
however, chosen to adopt neither of these modes, but to 
apply another principle and use a new remedy. 

1 have given the one per cent, solution of nitro-glycer- 
ine, of which he began by taking one drop, and this dose 
has been gradually increased until he now takes four drops, 
every four hours. This produced characteristic physiologi- 
cal symptoms. Its effect has been to quiet the tumultuous 
heart, to reduce the number of beats to about the normal, 
and to give them their proper force. 

You will probably say that this smacks of homoeopathy 
— giving for a tumultuous heart a remedy which increases 
the heart's movements and diminishes the inhibition. Up- 
on investigation, you will, however, find that the reasons 
for the prescription are perfectly sound. ' When a sufficient 
dose of nitro-glycerine is given, inhibition is diminished, 
the action of the heart is greatly increased, the peripheral 
vessels are dilated, there is frontal headache, flushing 
of the face and a feeling of warmth over the body. Such 
are the effects produced by a sufiicient dose of nitro-glycer- 
ine. In this patient the effect has been produced by four 
drops; he has frontal headache, dizziness, a subjective feel- 
ing of warmth of the head and face, and he has, also, some 
coldness in the extremities. This condition seems to be 
like the morbid state which we desire to relieve. I need 
not say that the condition produced by the remedy must 
be in antagonism to that produced by the disease. Given 
that condition of the motor and inhibitory apparatus pro- 
ducing the effect on the movements of the heart which I 



232 The Peoria Medical Monthly. 

have described, and giving a remedy which causes the dis- 
turbance mentioned, there are two forces acting: one, the 
condition of disturbance produced by the disease; the other, 
the condition of disturbance produced by the remedy: the 
result 01 this being a state ot equilibrium. Two forces of 
equal momentum and volume, meeting in opposite direc- 
tions, produce equilibrium. 

Applying these principles in the present case, we have 
succeeded perfectly in relieving the condition of the heart; 
its movements are now quiet and orderly. If, however, 
instead of being antagonistic, these forces had coincided, 
the disturbance of the heart would have increased. 

The most casual inspection of the patient shows that 
there is a lowered condition of vital force. The heart 
behaves in this abnormal manner because the evolution of 
nerve force, not only in the cardiac ganglia, but also in 
other parts, is not performed in an orderly manner. The 
blood is impoverished, the nervous sj^stem inadequately 
supplied with ma,terial, and its functions are therefore per- 
formed irregularly. In order to give permanent relief it is 
necessary to tone up tho forces of the body, to restore di- 
gestion and improve nutrition, and especially the nutrition 
of the nervous centres. This is to be accomplished by the 
use of those agents which promote digestion — ^by a combi- 
nation of mineral acids with digestives. We give a tea- 
spoonful of Schaffer's solution of pepsin and five drops of 
diluted muriatic acid, to be taken directly after meals. 
Something is required to remove the excessive mobility of 
the nervous centres. The remedy best adapted to accomp- 
lish this, under the present circumstances, is the arseniate 
of iron. This we combine with strychnine as a tonic to 
the nerve centres. 

HYPOCHONDRIASIS. 

We have here a case which is by no means uncommon, 
and apparently not very important; still, it is exceedingly 
harassing and difficult to treat. This person has a marked 
depression of spirits — hypochondriasis; he has disordered 
digestion and a feeling of uneasiness, especially in the 
right hypochondriac region. The ancients recognized a re- 
lation between disturbance in the hypochondriac region 
and certain montal states, a fact shown by the term "hy- 
pochondriasis." Fneasiness in the right hypochondrium, 
disordered digestion, a feeling of weight after eating, are 
the symptoms referable to the stomach. The symptoms 
referable to the nervous system are the feeling of numbness, 
which is especially marked in the right wrist; tingling, 



Periscope and Abstract. 233 

which, at times, almost amounts to pain, which is pretty 
constantly present, and the condition the English designate 
"the iidgets," which is a peculiar subjective state situated 
in the extremities, and especially the lower extremities. 
It is a sensation of unrest — an intolerable disquiet — a feel- 
ing that it is absolutely necessary to move the member in 
order to obtain relief. Many nervous subjects suffer from 
this symptom to such an extent that, on the coldest night, 
they expose their feet to the air, preferring this discomfort 
to the terrible fidgets. All those symptoms, /. e., the hy- 
pochondriasis, the mental depression, the uneasiness about 
the hypochondriac region, the numbness and tingling in 
the right upper extremity and the fidgets in the lower 
extremities, are probably reflex and dependent on distur- 
bance in the digestive organs. In such cases there may be 
sweating, limited to one-half of the body or face; but this 
has not been present in this patient. 

I say that these symptoms are reflex and referable to the 
disturbance of the stomach, the route of transmission being 
through the semilunar ganglion and solar plexus, and the 
irritation is thus distributed to widely separated points. 

There is another element in this case to which attention 
must be called, i. e., constipation. This is probably due to 
the inhibition exerted through the same apparatus upon 
the intestinal movements. 

Such, then, are the terms of the problem before us. 
How are we to meet the indications? Having decided that 
the central difficulty is disturbance of the digestive organs, 
and that the reflex symptoms are grouped about this 
centre, of course, the first thing to be done is to restore the 
power of the digestive organs. He is a laboring man, and 
it will, therefore, be difficult for him to secure a diet 
exactly suited to his condition. It is not so much the 
quantity as the quality that is to be regulated. It is neces- 
sary that the food be of an easily digested and assimilable 
character. The digestion now labors. Any kind of food 
in considerable amount produces distress. 

The constipation must be relieved. Thus: — 

R . Extract! nucis vomicse, 
" belladonse, 

" pliysostig., aa gr. ^4 

" aloes, gr. )i M. 

Ft. pil. No. 1. 

A pill containing the above is to be taken three times 
a day. The nux vomica acts upon one part of the muscu- 
lar layer of the bowel, while the belladonna acts upon an- 
other part; the physostigma has a powerful effect in increas- 



234 The Peoria Medical Monthly. 

ing the secretion of the intestinal mucous membrane, and 
the aloes is, of course, directed more particularly to that 
condition which is called torpor of the intestine. This 
combination will not only temporarily relieve, but it will 
also pave the way to complete restoration. 

Something more is required. How shall the nervous 
distubance be relieved? These reflex symptoms are due 
to irritation of the terminal portion of the nerves in the 
stomach. The remedy best adapted to this condition is, 
under the circumstances, arsenic. We direct two drops of 
Fowler's solution of arsenic three times a day, before meals. 
This acts upon the terminals of the nerve, and upon the 
nervous apparatus. The pills may be taken two or three 
hours alter meals. I have another object in prescribing 
arsenic. It has a decided effect upon the mental condition 
to which we apply the term hypochondriasis. Independent- 
ly of the associated conditions, it promotes a feeling of well 
being. This is one reason why the arsenic eaters of Styria 
get into the habit of using the drug. It gives a greater 
zest to existence — developes the "animal sense of exist- 
ence," which, refine as we may, is a large element in that 
moral complex entitled happiness. 



How to Secure Good Dental Org^ans, Prevent Rickets, Hip 

Diseases, Etc. 

In the discharge of their duties, the physicians and 
dentists are daily asked by their patients, "What must I do 
to prevent my teeth from decaying?" The answer should 
be, "Correct your diet;" that is, eat such food, and only 
such, as contains all its natural elements. If we eat the 
products of grain, we must eat them with all their elements 
as furnished by Nature. If we eat meat, we must also eat 
bones, or our systems will suffer from a violation of one of 
Nature's unerring laws. It is conceded that dental decay 
is the dissolving away of the lime salts by vitiated secre- 
tions. This is not due so much to a want of cleanliness of 
the mouth as is commonly supposed; for it is not true that 
"a clean tooth never decays." One may devote twelve hours 
out of the twenty-four to the ablution of the mouth, and 
tail to prevent decay of the teeth, so long as Nature's 
dietetic hiws are violated. 

Dental development in man is discernible as early as 
the seventh week of intra-uterine life; hence the impor- 
tance of a strictly correct diet from the start, if mothers 
wish to give birth to children who may have perfectly 



Peeiscope and Abstract. 235 

formed teeth; and perfect health ir eludes a perfect set of 
teeth, for they are little indicators, denoting by their con- 
dition that of the whole system — just as a thermometer 
indicates thermal changes. A. mother who passes through 
the periods of gestation and lactation without a sufficient 
supply of bone and tooth material in her food, will suffer 
from loss of teeth, neuralgia, rheumatism, and other dis- 
eases that result from an impoverished state of the system. 
The lime from her teeth will be dissolved, taken into the 
circulation, and appropriated by the offspring. Excepting 
civilized man, all flesh-eating animals eat as much of the 
bone w^ith the flesh they devour as they can break with 
their teeth sufficiently fine to swallow. Place before a 
tribe of Indians everything the earth produces in the shape 
of food, and they will eat only animal food so long as that 
lasts; but put them upon a Reservation and feed them as 
civilized people feed themselves, and decay of the teeth 
soon follows. 

Take from any carnivorous animals their supply of 
bone which Nature furnishes with the flesh, and decay of 
the teeth is sure to follow. Several years ago, the lions in 
the Zoological Gardens of London were fed upon the thighs 
of horses. These being large and hard, they were unable 
to break and eat them, and as a consequence, their young 
were born with cleft palates, and died shortly after birth. 
They were afterwards fed upon deer and other small ani- 
mals, and their young were born with perfectly- formed 
palates, and lived. Veterinary surgeons have long known 
that certain diseases of their dumb patients can only be 
successfully treated by feeding them with bone-meal. A 
dam, too aristocratic to gnaw bones, gave birth to sncces- 
ive litters of rickety pups. After being fed with food con- 
taining bone-meal, she produced perfectly heaithy ones, by 
the sam.e sire. Even our domestic herbivorous animals 
thrive better when bone is added to their bill of fare. The 
cow, wdiich every year gives ])irth to young, has an exces- 
sive drain upon her supply of bone material, and craves 
bones to such an extent that she will try to masticate even 
very large ones, as every farmer's boy can testify. 

Arguments in favor of eating bone to prevent decay of 
the teeth, as well as to cure a long catalogue of bone kind- 
red diseases, might be continued indefinitely, but as "a 
word to the wise is sufficient," it seems only necessary to 
add that a long and continued experiment has been made 
upon a family, with results that fully justify all claims 
made for it. The bones were selected from perfectly 



236 The Peoria Medical Monthly. 

healthy animals, none being used that bore the slightest 
blemish, carefully cured without being allowed to pass 
through any perceptible chemical changes, finely granula- 
ted and incorporated into soup, gravy, bread, etc., in the 
proportion of from one to three spoonsful to each pint of 
soup, gravy or flour. The relative proportion of nutritive 
elements in one hundred parts of different kinds of animal 
food has been found as follows: — 

Beef, 26; mutton, 29; chicken, 27; pork, 24; brain, 20; 
blood, 21; codfish, 21; white of egg, 14; milk, 7; bone, 51; — 
H. E. Dennett, D. D. S., in Col. Clin. Eecord. 



Excision of the Tonsil. 



In a paper read before the Ontario Medical Association, 
and published in the Canada Lancet, Dr. Pyerson has the 
following to say on the above subject: The question, 
"When should a tonsil be excised?" is an exceedingly 
practical one which comes up for discussion almost every 
day in practice. The answer it would be well if possible to 
define precisely. The indications for excision I consider to 
be the presence of symptoms either of impaired nutrition 
with marked obstruction to respiration, frequent relapsing, 
inflammation or suffering in contiguous parts. 

Marked enlargement of the gland is almost sure to be 
accompanied by impairment of the general health, partly 
through the imperfect circulation of the blood, and partly 
also because of the broken rest at night. It is also proba- 
ble that the stomach suffers from the constant swallowing 
of unhealthy mucus. Obstruction to respiration is a 
serious matter in the young, inasmuch as it causes the de- 
formity of the chest, known as "pigeon breast." These 
symptoms demand the removal of the offending gland, 
because there is no time to wait for the slower action of 
internal and local remedies. The Eustachian tube and 
middle ear are very apt to suffer from inflammation by 
contiguity. The nasal mucous membrane also may, and 
frequently does present symptoms of severe inflammation 
and consequent obstruction of the nose. These symptoms 
also demand most urgently the removal of the tonsil. 

Tonsils, the seat of chronic relapsing inflammation, 
should be removed. Also cases of true pathological hyper- 
trpphy of the tonsil are best treated in the same way, 
medicinal treatment being nugatory. The tonsils are fre- 
quently enlarged in strumous and delicate children ; if 
there be no symptoms as before related, they are best left 



Periscope and 'Abstract. 237 

and treated by internal remedies, prominent among which 
are syr. of the iodide of iron and compound syrup of hypo- 
phosphites. Local astringents may also be used with 
benefit. In cases of follicular tonsillitis it is not often 
necessary to remove the gland. Local treatment with 
fused nitrate of silver on a probe applied to each follicle is 
generally successful. Mere enlargement of the gland with- 
out other symptoms, I do not consider to indicate its 
removal. 

With regard to the mode of operation, the cases must 
be selected. For large, prominent tonsils, especially in 
children, the tonsillitome is, in my opinion, best suited. 
In moderately enlarged and very hard tonsils, in true hyper- 
trophy and in the long, flat-shaped tonsil, the vulsellum 
forceps and blunt bistoury should be used. It is almost 
impossible, however, to use the bistoury in the case of 
young children, without an anaesthetic. I do not regard 
the danger of hemorrhage as a very serious one. It is very 
rare, and it can be controlled by pressure on the artery, 
local tampon, or in extreme cases by ligature of the carotid. 
It is most dangerous in children who do not know enough 
to assist, the operator. 



Some Facts about Koiimiss. 

I will not attempt to overhaul a subject which has 
been so generally written about and so generously discussed 
during the past few years, but beg simply to call attention 
to some facts with which I am personally familiar. I have 
been often asked why koumiss is not more generally used 
in the treatment of dyspepsia, consumption, and other 
wasting diseases, being known, by the majority of the pro- 
fession to ])e an excellent remedy for these conditions. 
My answer has invariably been that it is because the 
remedy is not available. Koumiss cannot be kept in stock 
by druggists during hot weather, or shipped, except on ice, 
and this precaution increases the expense very materially. 

Perhaps the most important factor which militates 
against the general use of koumiss by physicians is the 
w^ant of uniformity in the quality of the article. This is not 
to be w^ondered at when one remembers the number of 
published recipes (all different in some particular or other) 
that are floating around. Each interested individual 
imagines he can manufacture koumiss, and makes a trial. 

The scheme very often ends in failure, but if it does suc- 
ceed there are two chances against one that the remedy 



238 The Peoria Medical Monthly. 

will not be correctlj^ applied, and the result is that its repu- 
tation suffers. It is astonishing to see how few people can 
be instructed how to tap the bottle properly. In spite of 
w^ritten, and full verbal instructions, many persons allow 
the gas to escape and then wonder that the liquid should 
be flat and unpalatable. 

My experience shows that about three-fourths of the 
patients like to drink koumiss, and with the remaining 
fourth the taste is easily acquired. 1 have been prescrib- 
ing the agent for over five years and have not met a single 
patient who absolutely refused to take it ; moreover in all 
this time I liave seen but two or three cases where it has 
not checked vomiting when such a residt might reasonably 
have been expected. After consuming two or m.ore bottles 
of koumiss per day for several weeks, especially if other 
food has been restricted, most patients become tired, but 
readily return to it after a few days if, in the meantime, 
some easily digestable articles of food are substituted. 
The single fact that the stomach can tolerate koumiss when 
everything else is rejected and the appetite for it preserved 
for so long a time is enough to show how well adapted it is 
to the mechanism of assimilation. Not that it assists in 
digestion by any diastatic or peptic power of its own, but 
more by the influence it imparts to the organs of digestion, 
exciting them to a more vigorous performance of their 
functions. 

Besides the lactic and carbonic acids and small pro- 
portion of alcohol which act as a tonic to the peptic glands, 
the finely divided casein serves as a readily assimilable 
nutrient, making, together with the inorganic constituents 
of the milk, a- highly nutritious tonic. That it is pleasant 
to the taste is proved by the fact of its popularity as a 
summer beverage with persons in health. Nothing is to 
me more exhilerating or palatable on a hot summer day, 
especially after out door exertion, than a glass or two of 
the cool effervescent liquid. While nothing is so pleasant 
to drink as koumiss properly prepared, few things can be 
so abominable as it when poorly made or carelessly at- 
tended to, and I do not wonder that patients and physicians 
alike become often disgusted with the vile compounds 
palmed off on them under the name of koumiss. 

Having for a number of yeai's witnessed the good 
effects of the agent, and being familiar with the disap- 
pointments enrountei-ed in obtaining an excellent quality 
of it, I determined aliout a year ago to manufactui-e it my- 
self. Since that time 1 have kept it constantly on hand 



Periscope and Abstract. 239 

for the sole advantage of feeling certain that it is properly 
prepared and properly kept. I furnish it to my patients at 
the cost of making and never feel in doubt as to its action. 
Any physician who has a cellar, and is willing to go to the 
trouble, ean do the same thing. 

My plan is to send every morning to the patient's 
house the amount (one, two or more bottles) to be taken 
during the day. In the intervals of taking, the bottle is'to 
be laid down on its side either on ice or the cellar floor, 
and covered wdth some non-conductor of heat. 

When the hour for taking arrives the bottle along 
with a clean and polished glass is taken to the patient's 
room and the koumiss drawn before the patient's eyes. 
Drinking it down rather quickly is more satisfactory than 
sipping it, for the reason that the gas soon escapes and the 
foam disappears. 

After taking from one to four bottles in the twenty- 
four hours for several days in succession the most delicate 
stomachs are able to take other food in considerable quan- 
tity without apparent injury. My method is to mark out 
a course of diet, using special restrictions from time to 
time as necessity requires, and even stopping all food occa- 
sionally until the stomach can recuperate, which it seldom 
fails to do after a few days exclusive use of koumiss. 

The indications for the use of koumiss exist in all 
chronic wasting diseases attended with dyspepsia. It is 
especially applicable to consumption as most all such cases 
are attended with more or less disorder of the digestive 
apparatus. I believe that many cases of this disease can 
not only be averted but actually cured in the earlier stages 
by the use of koumiss and proper precautions as to fresh 
air. A most important measure in these cases is to admin- 
ister with each glass a sufficient amount ot sweet cream, 
which supplies carbonaceous matter in a manner where its 
assimilation is assured. Whether from the reflex action on 
the coats of the stomach or from the soothing influence of 
the alcohol it contains, 1 cannot say, but it often relieves 
the cough of phthisical patients, and promotes expectora- 
tion when ordinary measures fail. 

It produces its best effects in phthisis attended with 
chronic disorder of the digestive apparatus, but it is un- 
doubtedly of great service in many other troubles acute as 
well as chronic. My observation, however, has shown me 
that it is not a universal remedy for vomiting in acute 
cases, and I have more than once found it necessary to 
substitute for it the old and familiar "lime water and milk." 



240 The Peoria Medical Monthly. 

It is r.oreover. idle to say that it is indicated in every case 
of chronic stomach compkiint. Persons who use it a great 
deal will tind this out, but they will also discover that these 
exceptions are important evidence in its favor ; for it is a 
rare thing to obtain a remedy so palatable at the same 
time that it is so beneficial. — B. B. Davy, M. D., in Lancet 
and Clinic. 



Treatineut of Diabetes Mellitus. 

From Dr. Austin Flint's article on the above subject 
read at the meeting of the American Medical Association, 
and published in the Association's Journal we abstract the 
following '^summary of treatment :^^ 

The more I study the cases of diabetes that have come 
under my observation, especially those that are now under 
treatment, in connection with the writings of those who 
have faithfully followed the dietetic plan, notably Bou- 
chardat and Cantani, the more thoroughly am I convinced 
that the prognosis in a recent and uncomplicated case of 
this disease in an adult is invariably favorable, provided, 
always, that the proper measures of treatment be rigidly 
enforced. In the hope ot convincing the profession that 
this statement is reliable, I shall at the risk of what may 
appear to be needless repetition, give a summary of treat- 
ment. At the outset, patients should be impressed with 
the fact that they are suffering from a grave disorder, and 
that everything depends upon their full co-operation in the 
treatment, which treatment is essentially dietetic. The 
diet table should be carefully' studied, and the diet regu- 
lated and carried out absolutely. 

In case a rigid anti-diabetic diet does not promptly 
influence the glycosuria, it may be well to subject a patient 
to an absolute fast for twenty-four hours and follow this 
with the anti-dial)etis regimen. This rather harsh measure 
is suggested by Cantani. I shall not hesitate te employ it 
in cases in which it may seem to be required, although no 
such case has as yet come under ray observation. 

The various measures that I have mentioned under the 
head of General Treatment should be enforced, especially 
systematic daily muscular exercise. A moderate system of 
training on the plan adopted by athletes is most useful; 
and tins, if continued, will do much to render a cure per- 
manent alter a return to the normal diet. 

The return to a normal diet should be gradual, and 



Periscope and Abstract. 241 

during this time the urine should be frequently examined, 
the rigid diet being resumed at. the first re-appearance of 
sugar m the urine; but all alcoholic excesses, the immoder- 
ate use of sweet fruits, and any use of sugar should be in- 
terdicted at all times. A patient who has once had diabetes 
is always liable to a return of the disorder. He must lead 
a thoroughly careful hygienie and temperate life. In the 
words of Bouchardat, "you will never be cured except on 
the condition that you never believe yourself to be cured." 

While I believe that the physician is justified in 
encouraging patients to expect relief, and even cure, in 
recent, uncomplicated cases, the diet is all important, and 
its regulation cannot be expected to be perfect without 
professional aid in its enforcement. A diabetic is never 
safe from a return of his disease, even when he believes 
himself to be cnred; and under no circumstance should he 
pass more than a few weeks without an examination of the 
urine. 

The arsenite of bromine, or Clemen's solution, appears 
to be useful. We may begin with three drops three times 
daily in a little water immediately after eating, gradually 
increasing the dose to five drops. This may be continued 
for weeks and months without producing any unfavorable 
efi'ects; but the administration of this remedy does not 
supply the place of the dietetic treatment, which should be 
enforced in all cases. A rigid diet should be continued for 
two months, at least, even in the mildest cases of the 
disease. It may be necessary, in certain cases, to continue 
it for a longer period, even twelve or more months. 

There is probablj^ no such disease as intermittent 
diabetes. In some instances glycosuria occurs during the 
season of sweet fruits, when they are indulged in exces- 
sively, and disappears when the diet is changed; but these 
are mild cases of diabetes, excluding those in which a tran- 
scient glycosuria follows the inhalation of irritating vapors, 
the taking of angesthetirs. etc. 

Robust or corpulent persons are more tolerant of the 
disease than those who are feeble or spare, and the gly- 
cosuria yields, in such casee, more readily to treatment. 

Diabetes occurs at all ages. The most unfavorable 
■cases are those which occur before the age of puberty. An 
adult male presents the most favorable conditions for cure. 
In old persons, when the disease is of long standing, the 
dietetic treatment will secure practical immunity from 
nearly all the distressing symptoms, although the gly- 
cosuria may not be entirely removed. 



242 The Peoeia Medical Monthly. 

Danger in Using- Jequirity. 

In a paper read before the Philadelphia County Medi- 
cal Society, and published in a recent number of the 
Journal of Auiericcui Medical Association, Dr. M. Landesberg 
takes occasion to sound a note of warning as to the dangers 
accompanyin£>- the use of the suddenly popular remedy, 
jequirity. He says, '"The medical journals have not failed 
to inform their readers that a new remedy has been intro- 
duced by Wecker into the oculistic therapeutics, which, by 
its prompt, energetic and sure action in trachoma and 
pannus, by far surpasses all the other methods of treatment 
ordinarily used in this atfection. These glad tidings have 
been corroborated by the casual publication of notes and 
comments on the many excellent results obtained by 
Wecker and his followers by the new procedure, which 
consists of applying an infusion of jequirity, of a given 
strength, to the surface of the palpebral conjunctiva, in 
order to produce rapid suppuration, and by means of the 
latter to promote absorption of the trachomatous infiltra- 
tion." 

Dr. L. further remarks that he has no where seen any 
medical paper dwelling upon the great dangers in which 
the eye is apt to be involved by such process of suppura- 
tion, and possible excess of reaction. Even fatal con- 
sequences may develop. He would show the reverse as 
well as the glittering side of the medal. The general phy- 
sician is not in position to follow all the intricacies of the 
experiments with the new drug. "He finds jequirity highly 
spoken of in his journal, and he avails himself of the 
opportunity to win by easy means the battle and the 
honors connected with it. But it happens sometimes that 
he makes matters worse and the organs existence is endan- 
gered by the treatment. Incidents from experience of 
general practitioners in different parts of the country prove 
frequency of such results. There was excess of reaction in 
some instances, and implication of the cornea in others." 

In answer to many inquiries the Dr. says "the question 
is by no means ripe for verdict," but that he has no cause 
to abandon his usual method of treatment for the new. and 
concludes with the following results in nine cases: 

"The result of treatment with jequirity was negative in 
five cases of trachoma and pannus. There was no improve- 
ment whatever, but no injury done either. Two cases 
presented witli trachoma and pannus, deep (corneal ulcera- 
tions, which were asserted to have developed during the 
treatment with jequirity. Before the latter had been 



Periscope and Abstract. 242f^ 

started the patient had enjoyed fair vision. One patient, 
with xeropthalmus of both eyes, suffered the loss of the 
right eye in consequence of pan-ophthalmitis, which had 
set in on the fourth day after the application of jequirity. 
There was not the slightest improvement in the lelt eye. 
A girl who had done nothing for her eyes up to the time of 
the treatment with jequirity, presented herself six weeks 
later with the following condition: Lids thickened; palpe- 
tral conjunctiva intensely swollen, covered thickly with 
large granulations and furrowed with tendinous cicatrices. 
Both cornese opaque and vascular. 



The New Officinal Chlorate. 

The Journal of the Arnerican Med. Association, for July 
19, contains the paper of Dr. Traill Green, of Easton, Pa., 
read at the meeting of the American Medical Association 
before the section on Practice of Medicine, on the above 
subject. The paper contains many points of practical im- 
portance, a synopsis of which we will endeavor to give, as 
below. 

Dr. Green says, "The introduction of the chlorates of the 
stronger alkaline metals makes an important era in thera- 
peutics," and then proceeds to give a history of the same 
and their application to the cure of disease. The sodium 
salt he considers far superior as a remedy to the potassium, 
and continues: "I see cases constantly which prove its 
superiority. It is very well known that the potash salt is 
freely prescribed in almo.st every family without the advice 
of the family physician. I am called very frequently to 
prescribe for cases so treated which have remained ill for 
some time under suitable doses of the potash salt. Under 
the use of the sodium chlorate I find such attacks yielding 
very soon." 

And again: "Having observed the good effects of the 
sodium chlorate in vaiious inflammations of the mucous 
surfaces, I was led to use it in cases of inflammation of the 
skin produced by rhus toxicodendron, and I found it very 
eff'ectual, its early use arresting the inflammation very 
speedily, and when the inflammation had advanced before 
I was called to treat it, I found that it aJlayed the itching 
and burning, and hastened the healing of the inflamed 
parts. In cases of this kind I have used four to twelve 
grains of the salt to 500 cubic centimeters of water (one to 
three drachms to a pint of water.)" 



244 The Peoria Medical Monthly. 

Dr. G. uses the sodium chlorate in inflammations of 
mouth and throat; also in erysipelas, with good therapeutic 
results, keeping cloths wet in a solution of it applied con- 
stantly to the parts. Also for the itching and burning sen- 
sation in scarlatina. It should be remembered in using 
chlorate externally to keep cloths from the fire, as they 
burn with great activity and ignite readily. 

It is useful in conjunctivitis and inflammation of the 
eyelids, in all infl_ammations of membranes terminatmg in 
the skin, in piles, inflammation of external ear and nostrils. 
Very eftectual in nasal catarrh, and in fact more rapidly 
curative in any case where the potassium salt is found 
useful. 

The greater solubility of the sodium salt is very advan- 
tageous. It is more pleasantly received by the system 
when taken internally. The same is true of the sodium 
iodides and bromides. With a full knowledge of their 
relative properties, the Dr. feels assured that any one will 
always choose the sodium instead of the potassium salt. 



Bergh on Pasteur. 

That prince of fanatics, Mr. Henry Bergh, of New York 
City, has addressed a letter to the President of the Pans 
Society for the Prevention of Cruelty to Animals, in which 
he takes occasion to refer to M. Pasteur in the harshest 
language. Mr. Bergh says: " In the outraged name of 
science this merciless empiric is poisoning the flocks and 
herds of France after the fashion of his predecessor, the 
notorious Jenner, of England, who nearly a century ago 
commenced inoculating his countrymen with a noxious 
mucus taken from diseased animals, under the pretence of 
preventing and curing small-pox." 

Again, he says: "A French Jenner now crawls to the 
earth's surface and begins the fiend-like and disgusting 
work of polluting the bodies and flesh of the lower ani- 
mals ; moreover, it is proposed in the Chamber of Deputies 
to reward this man's detestable crime by voting him a 
pension also." Such is the estimate placed upon the work 
of Jenner and Pasteur by the great would-be philanthrop- 
ist and l)Ciior;ictor of dumb brute creation. No one doubts 
the fad tiud Mr. Bergh is sincere and honest in the views 
he holds, and we would not attempt to underrate the value 
of his eminent services in the prevention of cruelty to 
animals. Vs Vj think Mr. Bergh has greatly exceeded the 
limits of hi.; usetul sphere of action, and from the high 



Periscope and Abstbact. 245 

position as a benefactor of brute creation has fallen to the 
lowest plane of fanaticism possible to be reached. Like 
many reformers Mr. Bergh would reform too much. In his 
earnest desire to carry out his views he has exceeded all 
bounds of reason, until he is simply a fanatic without 
reason. Herein lies the danger ot fanaticism, which seems 
to take possession of many men of earnest character and 
purpose like Mr. Bergh. An ideal standard is erected, and 
every action must conform to the one-sided view of human 
conduct. Such men become intolerant and impatient of 
those who do not see as they see and act as they act. In 
their earnest desire to carry out their own extreme views 
they are often guilty of the insane ravings which have so 
often escaped the lips of Mr. Bergh. — Maryland Medical 
Journal. 



Physical Signs of Consiimptiou. 

Dr. C. W. Kelly, of Louisville, concludes a clinical 
lecture on the above subject, published in the Medical 
Herald, as follows: 

Let us recapitulate briefly the signs which are of import- 
ance in the torming stage of the disease. By inspection 
we usually get depression above and below the clavicle on 
the affected side and notice that although the respiration 
is more rapid than normal, there is either partial or com- 
plete immobility of the depressed portion and fixation of 
scapula and shoulder of aflected side. Palpation informs 
us that there is an increase of vocal fremitus on the affected 
side. Now if this increased fremitus occur at the upper 
portion of the right lung it is of but little value, for we 
know that there is naturally a slight increase on that side 
from the position of the bronchus, but should we elicit the 
same sign on the left side it becomes of considerable im- 
portance as an evidence of deposit. 

The percussion note is usually dull or at least dimin- 
ished in clearness if the consolidation be at all superficial, 
but it may be necessary to strike the chest wall forcibly in 
order to get dullness if the deposit be deep seated and 
healthy or emphysematous lung tissue exist between it and 
the surface. 

By auscultation we may notice what is termed "cogged 
wheel" or wavy respiration. To this, as an evidence of 
tubercle, we attach little or no importance, for it is fre- 
quently heard in health, especially in children. 

An interval between the respiratory acts with pro- 



246 The Peoria Medical Monthly. 

longed expiration of high pitch is one of our most positive 
signs. Remember, however, that simply prolonged expira- 
tion without alteration in pitch is of no consequence. 

In the early stages of the disease respiratory or vesicu- 
lar murmur is feeble or at least is irregular, being feeble in 
any portion of the lung and slightly increased in another. 
Most usually the heart-sounds are more distinctly heard 
over aiiected lung, which fact should be borne in mind as 
the physician's attention is often called to this indication as 
the site of trouble. 

The physical signs of this stage depend largely on the 
physical signs of the diseases which the presence of tuber- 
cle excites. Foremost among these are pneumonia, bron- 
chitis and pleurisy, their frequency being in the order 
named. Circumscribed crepitation, bronchial rales, either 
dry or moist, limited to a small space, or pleuritic friction 
sounds heard here and there over certain portions of the 
lung are among our most reliable proofs of the presence of 
tubercle. Bear these points in mind, gentlemen. 

When the disease has advanced to the third stage and 
ulcerative changes have taken place, then indeed is the 
diagnosis a simple matter, but unfortunately the presence 
of the enemy has been discovered too late — the alarm is 
useless. Practice physical diagnosis ; practice it among 
yourselves ; become so familiar with the sounds of health 
that you can with ease and certainty detect the slightest 
abnormal departure. 



Worms in the Ear. 



Dr. Barrett reports (Southern Practitioner) tiis case of 
a child eighteen months of age from whose ear he extracted 
a worm of the species Ascaris Lumbricoides, four laches in 
length, and wishes some meml)er of the profession to 
inform him as to how a worm of such dimensions could 
possibly reach that point. 



Cod jLiver Oil. 



One of the easiest ways of administering cod liver oil 
is' with the yellow of an egg, a drop or two of an essential 
oil and half a glass of sweetened water. — Cincinnati Lancet 
and Clinic. 



Periscope and Abstract. 247 

Vaginal Application of Phenic Acid,. 

In the Cincinnati Lancet and Clinic for August, Dr. 
Bigelow, of Washington, has an article on gynecological 
practice in which occurs the following: 

Any carbolic acid in the market, even Calvert's No. 1, 
contains more or less of a poisonous and highly irritant 
body cresylic acid, as well as rasacic acid and rosanaline. 
In 1871, Dr. Declat, of Paris, commenced a series of exper- 
iments which resulted in the discovery of the pure and 
nascent phenic acid bearing his name, which is chemically 
pure, which does not change into rosacic acid and rosana- 
line on exposure to air, light and moisture. This is a 
valuable addition to our materia medica. The dissatisfac- 
tion which has so often found expression in the medical 
journals by physicians, has in the main been due to the 
impurity of the article used. I have used Declat's pure 
nascent phenic acid, which is combined in its nascent state 
with a deoxydizing base, very freely and always satis- 
factorily. An article on this subject which appeared in the 
New York Medical Journal of March 20, 1884, lent addi- 
tional courage to its internal administration, and I have 
seen forty grains taken at once without deleterious effect. 
I am in the habit of using glyco-phenic, which is a ten per 
cent solution, in my office practice for all disinfecting pur- 
poses. In leucorrhcEa I either spray the vagina with it or 
saturate a cotton tampon with it and allow it to remain 
in situ for two or three days. As I rarely if ever make use 
of a pessary, but always of a tampon, I very frequently 
use this preparation as a disinfectant. At other times, 
especially if there be ovarian irritation, I use a mixture of 
of iodoform, eucalyptus globulus and glycerine. Pulv. 
tannin, or the glycerate of tannic acid is valuable when we 
wish to excite the action of the vaginal walls, so that they 
themselves may be made to act as a pessary. I have used 
hypodermic injections of phenic acid in puerperal septi- 
cemia, alternately with phenate of ammonia as an anti- 
pyretic; in enlarged scrofulous glands, though here it is 
better to use iodo-phenique; in one case of a small subper- 
itoneal myofibroma of the uterus, and in one case of 
malaria, which happened to a patient at a time when I was 
treating her for uterine displacement. I have never had 
an instance of resultant abscess, and, if the needle is 
properly used, there will be no pain. Not infrequently it 
has been my habit to prescribe glyco-phenique as a daily 
vaginal wash for women who complain of a troublesome 
ichorous leucorrhoea, and it has always met and conquered 



248 The Peoria Medical Monthly. 

the indications which called forth the prescription. I sup- 
pose there can be no doubt of the value of pure carbolic 
acid in the light of recent physiological investigation, and 
the impetus given to pathological studies. 



Cholera. 

The folloyving simple suggestions cannot be too widely 
nor too well known when there is danger of a cholera 
epidemic: 

1st. Cleanliness of person and surroundings. 

2d. Great care in food and drink, avoiding all excess 
or abstinence and sudden changes from what one has been 
accustomed to. 

3d. Avoid fatigue of body or mind and any excess of 
any kind. 



Cholera germs require an alkaline medium for their 
development. For this reason acids should be used freely 
by those exposed to the poison. The mineral acids, pre- 
ferably the aromatic sulphuric acid, have proved to be the 
most efficient prophylactics ever tried, and their value 
should be more generally acknowledged. — Medical World, 



Universal Erysipelas in Cliild Aged Ten Months with Recovery. 

Dr. John Ferguson, of Toronto School of Medicine, 
has the following in a late number of the American Journal 
of Ohfitetrics: 

This case is interesting for the following reasons: In 
the first place, the entire surface of the child became grad- 
ually involved, and, in the second place, as illustrating the 
value of sustaining treatment. 

My first viiiit was made to the little patient on 8th of 
May. I was informed that the disease commenced on the 
day previous, as a reddish -swelling on the right labium. 
When I saw the patient for the first time the vulva was 
greatly swollen, reddish, slimy, and very tender. The 
inflammation had also extended on to the pubes and 
slightly on the lower part of the abdomen. 

From this time the disease marched upwards and 
downwards over the surface of the body, requiring about 
four days from its appearance at any part until it became 
nearly normal again in color. 



Periscope and Abstract. 249 

When the erysipelatous inflammation extended to the 
ieet there was ver}^ mark9d oedema. The chest, back and 
arms were also taken in turn. The neck and head were 
next invaded. The eye-lids and lips were the last points 
of attack. In this manner every portion of the entire 
surface of the body — not omiting the palms of the hands 
and soles of the feet, which had a tinge of red — was affect- 
ed at some time during the course of the disease. 

The local treatment consisted in frequently and thor- 
oughly anointing the skin with the following: 

Acid, carbolic! 5 grains. 

Ext. belledonnfB 15 grains. 

Ung. petrolei 1 ounce M. 

Soft clothes were kept next the skin and child loosely and 
comfortably covered. 

The internal treatment consisted in the administration 
of one teaspoonfull every three hours, in water of : 

Quin. sulph, 4 grains. 

Acid, liydrochlor. dil, 82 minims. 
Tr. ferri chloridi, 4 fl scruples. 

Syr. simp., 2 ounces M. 

As the child was nursing, no other form of food of any kind 
was given, nor alcoholic stimulants. 

The duration of the attack, from its commencement 
at the vulva to its disappearance at the eyes and mouth, 
was fifteen days. 



Partial Placenta Previa. 



As anything in the way of honest practical experience 
with placenta previa is of interest and value to every 
general practitioner of medicine, we give the following 
report of a case before the Obstetrical Society of Phila- 
delphia by Dr. W. T. Taylor, with its attendant discussion 
as given in the American Jouimal of Obstetrics for August. 

Mrs. S., an English woman, aged forty-six years, the 
mother of ten children, came to see me in December, 1SS3, 
in consequence of abdominal pains, headache, and vertigo, 
with a suppression of her menses, which was attributed to 
a "change of life," as she had been irregular for a year past. 
She also had numbness, with tingling dn the hands and 
feet, and had not been so affected in any other former 
pregnancy. Consequently she would not believe in her 
condition until some weeks later, when she quickened. 
In the month of February last she had enlargement of the 
veins of the legs, with oedema of the feet and ankles, for 



250 The Peoria Medical Monthly. 

which she took occasional doses of potassium bromide 
with a solution of cream of tartar (one ounce to water 
one pint) to be taken freely. By this treatment she was 
temporarily relieved. 

On March 27th she had abdominal pains and a 
profuse hemorrhage, which saturated her clothing and 
greatly alarmed her. On examination I found the os uteri 
high up and slightly open. Although the hemorrhage 
diminished, yet the pains would recur at intervals, and I 
fully expected labor would soon begin. Under the use of 
equal parts of wine of ergot and solution of sulphate of 
morphia, she began to get easier, and in a few days was 
out of bed and able to resume her household duties, feeling 
more comfortable, as the enlarged veins were smaller, her 
feet and ankles had diminished in size, and the headache 
gone entirelj^ I told her that nature had come to her 
relief and bled her without my ordering it. 

Feeling satisfied that this was a case of placenta previa, 
and that there was no immediate danger, I concluded the 
most prudent course to let nature alone, and wait until 
labor began. She had no more trouble until May 10, when 
she passed a large clot of blood and complained of slight 
pains in the abdomen. These occurred occasionally for 
two days, when the membranes ruptured, and a sudden 
gush of water, followed by a flow of blood, indicated that 
labor had begun. On examination I discovered within the 
OS a spongy, ragged, bleeding mass of tissue, which was 
recognized as the placenta; with each pain the flow of 
blood increased as the cervix dilated. Sweeping my index 
finger around within the mouth of the womb as far as I 
could reach, to detach the placenta from the uterine walls 
and assist the first stage of labor, 1 felt the fetal head 
beyond. 

To arrest the bleeding which, if it continued, would 
exhaust the mother and destroy the child, I plugged the 
vagina completely with strips of old muslin well saturated 
with lard, and waited patiently for the os to dilate and the 
head to advance giving at the same time occasional doses 
of quinine and wine of ergot as a tonic and stimulant. In 
about an hour the advancing head had expelled a part of 
my tampon, and, on removing the remainder, I found that 
the bleeding had ceased, and the vertex was presenting in 
the left occipital-posterior position. Auscultation revealed 
a feeble fetal circulation, but as the pelvis was roomy and 
my patient somewhat exhausted, I gave her freely of milk- 
punch until her pulse became stronger, which it did in half 



Periscope and Abstract. 251 

an hour, when, as the head had ceased to advance, I applied 
the forceps and delivered her of a medium sized girl, which 
in a few minutes began to cry with some vigor, contrary to 
my expectations, for I had told them it would probably be 
dead. Its vitality had probably been preserved by the 
adhering part of the placenta, which then came away quite 
easily. A teaspoonful of fluid extract of ergot contracted 
the womb firmly. The patient was weak for several days, 
but under the use of tonics with nourishing food she soon 
recovered her usual strength. 

Discussion : Dr. A. H. Smith remarked that this case 
being partial and without profuse hemorrhage, could have 
best been carried through by rupturing the membranes 
and bringing down the head which would have stopped the 
hemorrhage as soon as it engaged in the superior strait. 
Dr. Smith asked the question: Under what circumstances 
are we warranted in interfering? If the hemorrhage is 
alarming and the patient exhausted, she is in a poor condi- 
tion to bear interference, and, on the other hand, we have 
no right to interfere if there is no pain or hemorrhage. To 
interfere by manipulation is very dangerous, unless the 
uterine contractions are rapid and effective after labor once 
begins. The position of the child should be carefully and 
accurately determined by external manipulation before 
interference becomes necessary, so as to know where to 
seek the feet if turning becomes imperative. 

When the placenta previa is complete, dilatation of the 
OS causes a terrific hemorrhage, the blood streams from the 
patient like water from a hydrant or a small fire-plug, and 
death comes very quickly. Only perfect knowledge of the 
condition of things and the position of the child will enable 
the physician to avert the doom. Now as to the tampon, 
I would not use it. It hides the hemorrhage which may be 
going on profusely behind it, as was so* vividly described 
by Dr. Goodell, in his paper on Concealed Accidental Hemor- 
rhage of the Gravid tderus in vol. 2, American Journal of 
Obstetrics, in which he showed that the woman might 
bleed to death without one drop of blood escaping 
externally. 

The tampon conceals the hemorrhage without neces- 
sarily preventing it, and while it remains in place, one 
hand of the physician should be constantly on the patient's 
pulse to note instantly any failure of the heart, while the 
other should be on her abdomen, to note any changes in 
size of the uterus or position of the fetus. In Dr. Taylor's 



252 The Peoria Medical Monthly. 

case the treatment was bej^oud criticism, because the re- 
sult has been happy. 

Dr. (xoodell ao-rees with Dr. Smith that placenta pre- 
via is the most formidable complication in obstetrics. No 
general rule can be made applicable to the treatment of all 
cases. In practical ones the membranes should be ruptured 
and the head brought down. It must always be borne in 
mind that, in these cases, implantation of the placenta has 
caused increased vascularity, and thickness of the cervical 
walls; they are easily ruptured, and if torn bleed profusely. 
There is greatei" danger of septicemia from absorption of 
decomposing lochial discharges, when passing over this 
surface if it is torn. He well remembered one case which 
he attended years ago in consultation with Dr. Augustine 
Fish, since deceased, in which, in consequence of what he 
now considers undue haste, lacerations of the cervix oc- 
curred, and although the labor terminated happily, sep- 
ticemia set in a few days later and resulted fatally. It 
would have been better in that case to tampon. When the 
placenta is not central there is very little danger; there is 
some. The tampon may be used, but the pulse must be 
constantly watched, and frequently abdominal palpation 
should be made. He had been struck with the method 
practiced by Dr. Ellwood Wilson t>ore than twenty years 
ago. It consisted in gentle digital dilatation of the os; 
introducing first one finger, then two, and so on ; as soon 
as sufficient space was obtained, he gave ergot, ma,de podalic 
version and delivered. Very few practitioners advise that 
method. Dr. Goodell had not met with many cases, and 
the one spoken of above was the only fatal one. He has 
used Barnes'. dilators, taxis, strength, and courage, and has 
tried to adapt his treatment to the indications of each par- 
ticular case. 

Dr. W. H. Pai'ish thought the tampon was not used as 
frequently now as it was a few years ago, either in the form 
of Barnes' dilators or the vaginal plugs. Under similar 
circumstances he would probably do as Dr. Taylor did. 
Partial placenta previa is not very dangerous, but in com- 
plete the hemorrhage is excessive. In one case he had 
tamponed for several hours, when the os being dilated, he 
etherized and rapidly delivered a living child. The mother 
was in imminent danger of death from hemorrhage. The 
abdominal aorta was compressed; ice was used to the 
cervix, l)ut without success. The hemorrhage was con- 
trolled by the application of a cloth wet with Monsel's 
solution to the denuded cervical and uterine surface. 



Periscope and Abstract. 253 

Dr. Taylor has used the tampon in several cases of 
partial placenta previa and in numerous cases of abortion, 
and has never yet had bleeding to go on behind it. The 
line of treatment practiced in this case has always proved 
satisfactory as regards results. 

Dr. Goodell remarked that the womb at term was 
large, and concealed hemorrhage might be free enough to 
cause death, but there was no such danger in an abortion 
at two or three months. 



Historical and Critical Notes on tlie Delivery of the Placenta. 

Under the above title a paper read by Dr. J. C. Reeve, 
of Dayton, Ohio, before the Ohio State Medical Society, 
{Columbus Medical Journal) contains allusions to many 
points of practical interest of which we make the following 
brief synopsis: 

'"Within a year a paper has been presented to one of 
the State societies advocating immediate removal of the 
after-birth as soon as the child is born. In one of the 
noted schools ot Europe, where all our young men go to be 
taught better things than they can learn at home, the 
opposite plan has been adopted, and the placenta has been 
allowed to remain until thrown off by the natural powers. 
Both these plans have been tried in the past and the record 
of their results is to be found in the history of obstetrics. 
It need scarcely be' added that both have been abandoned 
on account of the evils resulting from them." 

Rendering assistance to the natural powers only when 
necessary was the method of the ancients. "'During the 
middle ages the opposite plan was adopted," and the after- 
birth removed even before the cord was severed, at all 
hazards, under the impression that a contraction of the 
cervix might impiison it. Fatal consequences frequently 
resulted. Sudden manual extraction is recognized gener- 
ally as a dangerous process. A period of rest necessary for 
the recuperation of uterine force occurs after birth of the 
child, as first taught by Smellie. The doctrine of Hunter, 
to the effect that the extrusion of the placenta should be 
left entirely to the natural powers, even when wholly in 
the vagina, is just as reprehensible as another extreme. 

The practical lesson drawn trom the experiences of 

. these teachers of the past is not needed to-day, "except by 

the young accoucher." Few things are not more easily 

acquired than a due estimate of the importance of a regular 



254 The Peoria Medical Monthly. 

and gradual completion ol each step of the wonderful pro- 
cess of parturition.'' 

"The eft'ect of ergot in producing irregular contraction 
of the uterus and consequent difficulty in the delivery of 
the placenta is generally recognized." There was a time 
when the administration of the medicine was not uncom- 
mon to hasten the birth ot the child. 

The author says he learned to expect retained placenta 
whenever he had given ergot, and also an injurious influ- 
ence of the drug upon the child. Now we know that ergot 
should never be given before the birth of the child, or "at 
least only just as the head is clearing the vulva." 

As regards the etiological relation of removal of the 
placenta to inversion of the uterus, the Dr. says: "The 
truth is that not by any one mode alone does the inversion 
take place, but in various ways; sometimes it is caused by 
internal traction on a relaxed uterus, sometimes by external 
pressure on the same, and very frequently it is the result 
of active contraction of the organ itself, no impulse having 
been in any way given by the accoucher.'' The idea of its 
being always caused by dragging on the cord is, in the light 
of modern ooservation, absurd. 

The Dr. cites the cases ot Lee and other competent 
obstetricians to prove that child, placenta and uterus may 
be expelled together without interference of the accoucher. 
and continues: Although, over and over again, in lists of 
cases of inversion, "pulling at the cord by the midwife" is 
given as the cause. I believe that in many cases this is 
pure assumption, and that in the majority it is gross injus- 
tice. The annals of obstetrics show that ignorant mid- 
wives have done all sorts of outrageous things, but when it 
comes to in verting the uterus by pulling at the cord, the phy- 
sician is certainly more likely to do it than the midwife. He 
pulls in the axis of the straits of the pelvis, of which she 
knows nothing and a large portion of the force she applies 
is expended in drawing the cord against the pubes." 

Further, says the author, in substance, all know how 
fragile the cord is, and how unlikely force enough can be 
exerted to invert the uterus without a favoring condition 
or inertia of the latter. Tt is as' likely to follow Crede's 
method as any other. The character of preceding labor, 
if any should govern our expectations in regard to expul- 
sion of placenta.. "For safe delivery of placenta we must 
wait awhile; allow the uterus a time of rest, give the fibres 
time to undergo tonic contraction, and its ganglionic 
centres time to gather power for the final effort." 



Periscope and Abstract. 255 

Breech Presentation. 

The Massachusetts Eclectic Medical Journal advocates 
the use of the fingers instead of forceps in delivering the 
head in breach presentation. Deliver with the back 
superior— woman on her back; bring head below superior 
strait as rapidly as possible, after first drawing cord down 
to give it slack, then introduce the index finger of one hand 
into the child's mouth and compress the chin, while with 
the fingers of the other hand the occiput is elevated, thus 
making face present. Afterward introduce two fingers 
into the rectum of the mother, by which mean pressure can 
be exerted upon the vertex, pushing it upwards and out. 



The Midwife. 



The Louisville Medical News, of August 9, is authority 
for the statement that a death certificate recently returned 
to the health office of that city, executed in due form and 
signed by a well known physician, certified to the death of 
a woman and her child, the cause being set down as 
placenta previa, supplemented by the startling clause— 
"superinduced by the criminal carelessness of a midwite." 

The News says the item did not escape the eagle eye of 
the reporter, and the result was the physician was inter- 
viewed, eliciting the fact the midwife, who was engaged 
sometime previous to the confinement, w^as aware of the 
bleeding but treated it as a trivial matter until on the day 
of confinement when, doubtless being alarmed at the pro- 
fuseness of the hemorrhage, and not having the prudence 
to seek medical counsel or the moral courage to confess 
ignorance, she suddenly left the patient, promising to 
quickly return, but never did. "Late in the day the physi- 
cian was summoned; but not until affairs had assumed 
such a state that it was not possible to save either mother 
or child." 

From the frequency of such occurrences as the above 
it is argued with truth that "the midwife, as she is in our 
land to-day, is an evil which should be promptly mended 
or ended." "If it be not practicable to establish schools 
■ for the education of midwives, some means for promoting 
private study among them might be devised. Tracts for 
their enlightenment might be issued by the health boards, 
and in the larger cities a special course for their instruction 
at the regular medical colleges might be provided for, or a 
term of service prescribed under the direction of the staff 



256 The Peoeia Medical Monthly. 

obstetrician or resident physician in tlie lying-in-wards of 
the hospitals. 

"Whether these means of instruction be practicable or 
not it is clear that midwives should be required to show 
some certificate or other authoritative testimonial of com- 
petency." 



Retro-Pliaryngeal Abscess. 

In concluding his paper on the above subject in the 
Xe/r lorli Medical Journal of August 9, Dr. John Roe sums 
up the treatment from which we abstract the following: 

In all cases where pus can be detected it should be 
immediately evacuated. In fatal cases death usually re- 
sults from failure to suspect abscess and seek for it, failure 
to find abscess when suspected, failure to open promptly 
when detected, or from burrowing of pus into the deeper 
tissues, which may occasion softening or ulceration of the 
coats of important blood vessels or other tissues. From 
failure to timely detect and open many lives are lost. 
Method of opening and location of incision depend on 
seat of the abscess. If pointing or found bulging into the 
phaynx, a free incision into dependent is necessary only. 
If marked swelling of side of neck with formation of pus, 
external incision is also often necessary. 

The methods proposed for opening abscesses, from 
time to time, are trocar and canula, aspirator, guarded 
bistoury, and finger nail. The use of aspirators and trocars 
was suggested to prevent escape of pus into the larynx. 
Care should be exercised in their use lest injury be done 
the vertebra. Albert's plan is to make small incision at 
first, afterward enlarging it. 

Schmitz uses a knife of his own device, with concealed 
blade, to be thrown out when it is in situ against wall of 
abscess. 

Chiene proposes in every case the opening be made 
externally. 

It is advisable to open the abscess externally in all 
cases where it tends to point externally, and where pus 
tends to burrow and deeper structures threaten to become 
involved. 

■•This is advisable because — 

1. Thorough drainage can be maintained and no 
secondary operations are required. 

2. The pharyngeal wound is avoided in which foreign 
and irritating substances can lodge or sacks or pockets form. 



Periscope and Abstract. 257 

3. In cases of the necrosis of the vertebra, the open- 
ing of the abscess antiseptically and the use of antiseptic 
cleansing injections, give the patient the best chance for 
recovery. In some cases it is advisable to make both an 
internal and an external incision for purpose of thorough 
drainage. 

"In opening the abscess externally the incision should 
be made along the posterior border of the sterno-cleido- 
mastoid to avoid the large vessels." The cut is usually 
made with a knife, but those who have employed the direc- 
tor and dressing forceps, as recommended by Hilton, in 
opening deep abscesses where important vessels are in 
danger of being wounded, will never attempt it by any 
other method." 

Hilton's method is as follows: "An incision is first 
made in the skin. Then a blunt-pointed grooved director 
is pushed into the swelling down to the pus. Then a pair 
of small dressing forceps, with the blades closed, is forced 
along the groove down to the abscess, and by partly open- 
ing the blades on withdrawing the forceps, a free opening 
is made." 

"In all cases more or less attention should be given to 
the general constitutional condition." 



Skin Transplantation. 



In the Transaction of the American Ophthalmological 
Society, [Medical Becord) we find reported the following, 
from Dr. B. E. Fryer: 

"In this case, after removal of the epithelioma, a flap 
was taken from the fore- arm and applied to the raw sur- 
tace of the upper lid. No sutures were applied, but the 
flap was held in position by gold-beaters' skin plaster. 
Two layers of this were applied and allowed to dry. It was 
then found that they kept the edges of the wound in per- 
fect apposition. The lids were stitched together with fine 
silk sutures. As the patient, in returning to her home, 
would be exposed to cold, a pad of absorbent cotton was 
applied to protect the part. This was removed on the 
arrival of the patient at her home. On the eighth day the 
plaster was removed, and perfect union found to have oc- 
cured. Three months after the operation there had been 
but slight contraction. The doctor laid particular stress 
on this method of dressing these wounds. If the operation 
were done at the patient's house he would dispense with 
the pad of cotton. 



258 The Peoria Medical Monthly. » 

Calomel an Instantaneous Nervous Sedative. 

Dr. Hatcliett in Southern Clinic says: From a close 
observation of its action, I am more and more impressed 
with the belief that the remedial effects of colomel are 
often insfanfaneous; that it is a prompt and powerful ner- 
vous sedative, commencing its action as soon as it reaches 
the mucous membrane of the stomach. This may appear 
incredible to some, but why should it? If it acts on the 
nervous system at all, why should it not act instanta- 
neously? We must remember, it is the province of the 
nervous structure to convey impressions with electric 
speed; that it is composed of innumerable telegraphic fila- 
ments with their extremities ending and forming a com- 
plete network through the entire mucous membrane; and 
then it cannot appear so wonderful or incredible that 
calomel should instantly convey a sedative impression in 
cases of nervous excitement. 

About the year 1869, I was called at night to see a lad 
of about twelve years of age, who had been having convul- 
sions contiiuiously from ten o'clock a. m. to nine p. m. 
The intervals between the convulsions had continued to 
grow less until, when 1 arrived, there was hardly any in- 
terval at all. His father, meeting me at the door, said, 
"You have come too late, doctor. My son is dying." And, 
really, it seemed so. 

In the hope that some portion of it might reach the 
stomach, I poured a teaspoonful of dry calomel into his 
mouth, a good deal of which was blown out by his spas- 
modic breathing. I then mixed half a teaspoonful with 
syrup and placed it in his mouth. Within five minutes — I 
am sure it did not exceed that limit — his father said, "He 
is more quiet than he has been to-day." A lady friend, 
stand by, said, "Yes, more so than I have seen him." I sat 
by him and witnessed the gradually subsiding spasms 
until, after the lapse of thirty minutes, he sank into a com- 
posed sleep. 

I visited him the next morning. He had rested well. 
After a dose of oil, he had two moderate evacuations from 
the bowels. Without further treatment, he continued to 
do well, and the recovery was complete. 

If that were an isolated case, I should regard it now, 
as I did then, as a coincidence — that the disease had 
reached its culminating point and was on the eve of its 
departure, which would, probably, have been made with 
equal celerity had no remedy been given. My subsequent 
experience, however, has very positively impressed me with 



■ • Periscope and Abstract. 259 

the belief that, in the case related, calomel is fairly entitled 
to credit for the cure. My subsequent reading, also, has 
helped much to confirm my impressions. — Southern Medical 
Record. 



Chronic Dyspepsia. 

Dr. 0. F. Taylor says (in the Atlantic Journal of Medi- 
cine): "I wish to call attention to listerine for chronic 
dyspepsia. 

"W. H., age thirty-five, came to me for treatment of 
dyspepsia of long standing. His pain and discomfort was 
great, the stubbornness of the disease having produced 
mental depression and attendant evils. I put him on the 
following prescriptions: Listerine, two oz.; water, 4 oz.; 
one -teaspoonful before meals. After several weeks he 
returned much improved, and reported he was able to 
retain everything he ate with very little intestinal pain 
except when tempted to take heavy diet, such as fat meats, 
cabbage, etc. I then prescribed listerine. 4 oz.; water, 4 
oz.; to be taken as before, and he has since obtained com- 
plete relief, and is regaining flesh and spirits without 
further treatment. 

"I have had several such cases of stomach derange- 
ment, and the listerine certainly gives me better results 
than any other remedy, and I would not be without it. It 
controls acidity promptly, produces a cooling and pleasing 
sensation, and is grateful generally to a patient thus 
afflicted." 

Apropos of the above, we prescribed: Listerine, 2 
ounces. Teaspoonful after meals in water, for a case of 
chronic intestinal dyspepsia with very gratifying results. 

It is true the patient, an old lady, was not permanently 
cured of her trouble, yet the fermentation of starchy and 
saccharine food was arrested; consequently, gaseous dis- 
tension of the bowels and colic, which before had caused 
her painful and sleepless nights, were followed by ease and 
sound sleep upon taking listerine. 



Ammonii Phosphas, 



Phosphate of ammonia is made from dilute phosphoric 
acid, 20 ounces; aqua ammon. fort., q. s. It has a cooling, 
sharply saline taste, is insoluble in alcohol, but soluble in 
four parts of cold water. Dose, ten to twenty grains three 



260 The Peoria Medical Monthly.* 

times a day iu water, or barley-water. It is supposed to 
make more soluble salts with uric acid than those of soda 
and lime, and to be useful in gouty concretions, gout, and 
rheumatic gout. In uric acid gravel it is more than rivalled 
by borax, the utility of which is very great. It enters the 
urine from the kidneys almost unchanged, attacks the uric 
acid, which it decomposes, forming a soluble urate of 
sodium. Dose five to thirty grains. 



Food for the Febrile. 



Dr. Zasetzky [Vratcli) considers the question of food 
and drink, air and rest, for the febrile. He uncondition- 
ally repudiates the old doctrine of keeping the patients 
on a " hungry " diet, consisting of carbohydrates, and insists 
on the necessity of their sufficient feeding. Albuminates, 
fats, and carbohydrates must be represented in the food for 
the febrile exactly in the same porportion as in the food 
for the healthy. He supports this demand by the results 
of observation, according to which febrile patients assimi- 
late albuminates, fats, and carbohydrates in the same de- 
gree as healthy subjects. Food must be given to the 
febrile in comparatively small amounts at a time; it must 
be mechanically prepared for digestion and must well 
satisfy individual tastes and habits of the patients. The 
febrile must be allowed to drink freely, and to choose for 
drinking what they like (water, wine-and-water, tea, coffee, 
milk, toast- water, syrup and water, or fruit-juice in water). 
The temperature of the drink must vary according to the 
patient's state (that is, when fever is high, the drink must 
be cold; otherwise the patient may drink what he likes at 
the ordinary temperature). As regards the temperature of 
the air in which the patient breathes, the author comes to 
the conclusion that it must oscillate between 56 and 63 de- 
grees F., not exceeding the latter limit. The necessity of 
most carefully maintaining the purity of the air in the 
patient's room is placed by the author on a level with the 
necessity of good feeding. Passing to the last, but not the 
least, point of his article, the author substantiates his de- 
mand for the greatest possible amount of rest for the febrile. 
Having pointed out the well-known data referring to the 
influence of the muscular work on various systemic func- 
tions, the author mentions his own experiments on the 
healthy, tending to prove that moving about leads to an 
increase of from four to eighteen per cent, in the excretion 



Periscope and Abstract. 261 

of nitrogen in urine; most probably the influence of move- 
ment on nitrogenous metamorphosis in the febrile subjects 
must be still more powertul. — Medical Record. 



A Contribution of the History of tlie Ligation of the Common 

Femoral Artery. 

In a paper with the above title, contributed to the 
Medical News (July 5th, 1884), the author. Dr. L. McL. Tif- 
fany, of this city, sums up the following conclusions after 
a study of recorded cases: 

1st. Ligation of common femoral in continuity for 
distal wound is attended with great mortality, and should 
not be substituted for the application of ligatures to an 
artery above and below the point wounded. 

2d. Ligation of common femoral for elephantiasis or 
aneurism is proper. 

3d. The crural sheath should be freely opened and the 
vessel carefully examined for the origin of the profunda 
and epigastric, the ligature not to be tied within a half or 
three-quarters of an inch of either. 

4th. Half or three-quarters of an inch below Poupart's 
ligament will probably be the most favorable locality for 
the ligature. 

5th. The presence of a small branch near the seat of 
ligature does not contra-indicate the operation; such branch 
should be also tied. — Maryla^id Medical Journal. 



Expediency. 



The following suggestive paragraph occurs in a re- 
port of a number of fatal cases of puerperal septicemia in 
the Philadelphia hospital, by Dr. A. R. Johnson, in the 
Medical and Surgical Reporter of recent date: 

About this time an investigation was instituted to 
discover the cause of the malady. As a consequence, the 
resident who had been on duty in these wards was suspend- 
ed for two months, but was reinstated at the next weekly 
meeting of the same committee. This therapeutic measure 
of course did not effect the progress of the malady very 
much, but it showed the folly of a resident having too 
much of one kind of sickness, and suggested the more pru- 
dent course of rendering diverse diagnoses, and thus dis- 
tributing the cases to different parts of the hospital. This 
case was transfered. Not long afterwards, so the hospital 



262 The Peoria Medical Monthly. 

record says, case No. 116 died of malignant scarlatine, and 
the epidemic was arrested and the patients saved. If you 
don't believe it, look at the reports of the house. Of course 
other deaths from "chronic Bright's disease," "pulmonary 
congestion,-' etc., followed: But what have such things to 
do with obstetrics? The post-mortem appearances of 
those examined were strikingly similar to those of the 
patients that had died from the injfluences of the epi- 
demic, but in the present condition of science such things 
will sometimes occur. 



Aiiimouii Boras, 

Or borate of ammonium, is made from one part of boracic 
acid in three parts of warm ammonia water. It has a 
strong ammoniacal odor, and dissolves in twelve parts of 
cold water. It is used for urinary disorders with an excess 
of acid or earthy phosphates, and in irritability of the 
bladder. It has fallen into disuse, but is nearly as useful 
as borate of sodium. Dose ten to twenty grains largely 
diluted. It of course is one of the remedies for lithaemia, 
and has been used in low fevers in the place of the car- 
bonate of ammonia, especially when there is ulceration of 
the bowels- -Medical Record. 



Treatment of Ingrowing- Toe-Xail. 

Professor Petersen removes the whole of the soft part 
down one side of the nail, extirpates the nail itself, from 
antiseptic motives, and, after arresting bleeding by pressure, 
dresses the wound rapidly with oxide of zinc and cotton- 
wool. Fourteen days' rest in bed, with the foot raised, 
generally suffices for cure, and the contraction of the cica- 
trix prevents a relapse to the old condition. Professor Pe- 
tersen prefers general to local anaesthesia, on account of 
the troublesome bleeding afterward; and for the same rea- 
son he does not approve of Esmarch's bandage in this oper- 
ation. — Cin. Lancet and Clmic. 



Cure of Hydrocele. 

A correspondent asks for Levis' plan for the radical 
cure of hydrocele with carbolic acid. Ans. Tap the hyro- 
cele and inject from one to two drachms of 95 per cent, 
carbolic acid into the sack. If the fluid should again accu- 
mulate, remove it by tapping. It is then said not to return. 
— Medical Review. 



Periscope and Abstract. 263 

Tincture of Cantharides for Suppressiou of Urine. 

This drug is not usually recommended in such cases, but 
in the Boston Medical and Surgical Journal, March 22, 1884, 
Dr. W. C. B. Fifield reports a case, which he had seen in 
consultation with Dr. Rogers, of Dorchester. The patient 
was a hard drinker, whose symptoms were at first obscure, 
but who had later had albuminuria with casts. Complete 
suppression had lasted some days. Active treatment had 
been of no avail and the patient was comatose and failing. 
Tincture of cantharides was then given hourly in drop 
doses, and after some hours the secretion was re-established 
and the patient recovered so far as to be out. — Mass. Eclec. 
Med. Journal. 



The Globus Hystericus. 



Dr. Roth regards this symptom as due to a parassthe- 
sia of the sympathetic. And as the pellitory root has been 
found useful in paralysis of the tongue and pharynx, the 
author was led to try it in globus. He gives from ten to 
twenty drops of the tmcture of pyrethrum four times a 
day. He reports six cases in which he employed this rem- 
edy with satisfactory results. — Centralblattfur Gynakologie, 
May 3, 1884. 



Dr. Langenbeck, of Cincinnati, uses the following for- 
mula in chronic cystitis with great success: 

R. Bal. copaiba 10 drachms. 
Spls. nit.-£eth. 1 ounce. 

Sol. bimec. morpli 3 drachms. 

Syr. symp. 2 ounces. 

Aq. et acaciae pul 

q.s. ut emulsio 6 ounces. M. 

Sig. Teaspoonful three times a day. — Lancet and Clinic. 



Lsennec told one of his friends that he discovered the 
principle of auscultation thus: "One day in the court of 
the Louvre at Paris, he noticed children amusing them- 
selves by holding a cylindrical piece of wood to the ear and 
scratching with a pin the farther end. Thus they heard a 
louder noise than the pin usually produces. At his next 
visit to his patients in the Hospital Necker, he made a 
hollow cylinder out of a roll of paper and applied it over 
the heart of a patient. This was the first stethescope. 
After a time he used one made from cedar wood. In 1819 
he published his treatise on Mediate Auscultation. — Detroit 
Lancet. 



THE 

Peoria Medical Monthly. 

THOS. M. McILVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-JeflFerson Street, .... PBOKIA. ILL 

*»*Tlie Editor is uot responsible for the statements or opinions of contributors 

***yhort original articles are invited from any reader, whether a subscriber or not. 

*,*if extra copies are desired by a contributor, the number must be specified when 
the article is sent in to the Editor. 

**» All exchanges, books for review, and communications must be addressed to tha 
Ekiitor and Publisher. 

***Tlie puhUcatioii day of this journal is on or about the 15th of each mouth. 

**,To subscribers! A pencil mark at this place indicates that the time of your sub- 
scripiion has expired, and that a prompt renewal is urgently requebted. 



C^ditorial S^prtmettt. 



A Pleasure Trip. 

We have just returned from a two weeks vacation 
spent in Minnesota at the beautiful lake Minnetonka, 
wiiich must be our apology for the delay in this number 
of the Monthly. We spent several days in St. Paul and 
Minneapolis, and looked with wonder and amazement at 
the proi^^ress made by these twin cities since a previous 
visit two years ago. In that time both cities have doubled 
in population, and they are growing to-day as rapidly as 
ever. 

We were kindly shown through the Minnesota Hospi- 
tal College by the Dean of the Faculty, Dr. F. A. Dunsmoor, 
and found it well equipped for the work. This college has 
taken a high rank for the good work done by its faculty, 
and we are happy to hear that it is prospering satisfactorily. 
Its requirements are high and its examinations thorough, 
consequently graduates are well fitted for the profession. 
Minneapolis is siid to have over 300 physicians, and St. 
Paul not many less, which fact ought to prove that they 
don't need any more at present. We feel greatly benefited 
by our trip and come home with the determination to make 
the Monthly "boom" in more wavs than one. 



Editorial Department, 265 

Notes and Comments. 

Don't forget to send on your renewal when due. 

Dr. H. Steele, of this city is recuperating in Vermont. 

The British Medical Association has a membership of 
about 12,000. 

Dr. G. W. Piersol has removed from Hermon, 111., to 
Monroe City, Mo. 

Dr. Hammond's novelistic venture "Lai" has been well 
received by the critics. 

Sir Erasmus Wilson, F. R. S., the well-known English 
dermatologist, died August 10. 

Charles Reade called his dog "Tonic," because, he said, 
"it was a mixture of bark, steal and whine." 

Articles intended for publication in this September 
issue must be sent to us at once. We want to get it out 
jDromptly on the 15th. 

Send us the names of such of your professional friends 
and acquaintances . as you think would like this journal, 
and we will mail them sample copies. 

An elderly lady sent.for a doctor late at night because 
her mind was disturbed with the query, "whether it would 
be prudent for her to eat a baked apple the first thing in 
the morning." 

A surgeon need not fear a suit for damages from mal- 
practice if the value of his services have been acknowledged 
in a suit to recover the amount of his bill. . This is the 
burden of a recent legal decision. 

The United States Medical College of the City of New 
York "has returned to the nothingness out of which it 
sprang," is the way the Times of that city announces an 
adverse decision of the court of appeals. 

The actual expenses of the members of the American 
Medical Association during the late meeting have been 
estimated at sixty-five thousand dollars exclusive of w^hat 
they lost in f)ractice. — N. C. Med. Journal. 



266 The Peoria Medical Monthly. 

Dr. John Murphy has returned from his summer vaca- 
tion in Minnesota. The Dr. is a wonderful fisherman and 
celebrated his departure from the lake by catching a string 
of pickerel and bass weighing over 500 pounds. We saw 
the fish. 

It is stated that a wealthy London gentleman be- 
queathed over half a million dollars to his medical 
attendant. Our millionaire patients are respectfully in- 
formed that we will help them to die easily for half that 
amount. 

A case of poisoning from eating a half-hatched goose 
egg is reported. To persons suffering from such a depraved 
and incurable appetite we would recommend "Rough on 
Rats," or for the younger members of the family "Soothing 
Syrup." 

New York City has 1,789 registered physicians and the 
state 4,475. This is the official report, but we have reasons 
for believing that the register for the city is about 1,000 
short, and the state about 2,500 to 3,000 not registered or 
accounted for. 

We are heartily in favor of a Gross Memorial, but 
really do not like the idea of th^ whole medical profession 
being called on to endow a professorship in an already 
wealthy medical college. It looks as though "Jefferson" 
wa's making the most of its opportunity. 

"A young doctor who graduated at .Harvard met us 
here recently and asked us if Squibb 's preparations were 
used in St. Louis." — Weekly Medical Eevieitx The editor of 
the Review should not let such stories as the above get out 
on St. Louis as they will tend to injure the town. 

While in St. Paul we called upon Dr. Jay Owens, the 
genial editor of the Northwestern Lancet, and enjoyed the 
hospitalities of his home. The Dr. is a good sample of 
what the medical editor ought to be, which fact accounts 
for the fine growth and great popularity of the Lancet. 

The Pacific Medical and Surgical Journal and the 
Western Lancet have been united under the editorship of 



Editorial Department. 267 

Drs. Henry Gibbons, Sr., and W. S. Whitwell. The union of 
two such able journals ought to give the Pacific Coast one 
of the foremost medical journals of the country, and we 
believe it will. 

"Why, Cousin Charlie, what are you doing here! I 
suppose I must call you doctor now; how are your patients 
by the way!" 

"I don't know how they are by the way, I know none 
of them ever get as far as my office." — Life. 

Yellow tever is spreading rapidly in Mexico and the 
other countries of the Gulf. Cholera is spreading slowly 
throughout France and Italy. It is said, however, that the 
reports furnished the daily papers do not by any means 
represent the true state of affairs. It is much worse than 
reported. ^ 

Dr. T. F. Rumbold has resigned the editorial chair of 
the St. Louis Medical and Surgical Journal to Dr. LeGrand 
Atwood, and has gone to Europe for rest and the prepara- 
tion of a new edition of his work on Catarrh. Dr. 
Atwood needs no introduction to the readers of current 
medical literature. 

Crematories have been established in Pittsburg, Pa., 
and Buffalo, N. Y. The Record says: "They will conduct 
cremation on a business basis and doubtless will find 
enough 'cranks' to keep their furnaces supplied," from 
which we infer that the Record is opposed to this method of 
disposing of dead bodies. 

Fort Worth, Texas, is to have' a medical college. The 
best advice we can give them is, buy an old one, don't start 
a new one. There are probably fifty or more that can be 
had on favorable terms, and the removal of one to the far 
southwest would relieve the congestion to some extent. 
Don't start a new one but buy an old one. 

The staid old Chicago Medical Journal and Examiner 
has made a change in the right direction. It has a new 
cover, lessened its pages, reduced its price, improved its 
general appearance and has a live corps of three editors, 



268 The Peoria Medical Monthly. 

Drs. Hyde, Jagf^ard and Meyer. We congratulate the 
management on the changes, and predict the result of a 
resurrection. 

Dr. J. E. Weist, in a paper read before the Indiana 
State Medical Society, says that in "Henry county alone 
judgments have been entered against physicians falsely 
accused of malpractic' > to the amount of fourteen thousand 
dollars." He asserts diat each suit was encouraged by 
some rival of the doct( r mulcted. When will medical men 
learn that their real interests are one? Any injustice done 
to one member reflects upon the rest. 



Receipts. 

Any one who has forwarded money during the month, 
not otherwise receipted for, will please notify the publisher 
at once, if his name does not appear on this page in the 
next issue: 

Illinois— Drs. H. Kruse (!^2.00), Jos. Studer (••$2.00), D. P. McClure, A. L. 
Craig, S. B. Latham, J. S. Geigley, R. N. Barnes, G. F. English, G. P. Ransom 
($2.00j, W. H. Day (.^3.00), G. W. Remage (^0.50), E. Blanchard ($3.00), S. F- 
Bennett, J. F. Cooper, W. T. McLean, F. N. Odbert, C. W. Durst, Jno. Cole, C. 
Goodbrake (|2.00), H. Schscfer, W. H. Githens, Phil Sattler, Thos. A. Horine, O. 
F. Taylor, H. Knappenberger, C. L. Hatfield. 

\V.\sinx(iTON, D. C. — Library Surg. General's office (-•^S.OO). 

Iowa— Drs. E. J. Chapman, D. W. Jackson, A. O. Strout, J. P. Von Stein, E. 
A. Whetstine (.^2.00), W. D. McConnaughey ($2.00), Jos. A. Treat, E. S. 
Edwards. J. II. McCune, G. T. Nelson, H. Moulton. H. J. Saunders, A. L. Brooks 
($2.00), S. W. Cox. 

K.\.N-SA.s— Drs. W. H, Caulk, W. M. Washburn, Burtley Smith ($2.00). 

Missouri — Drs. W. S. Saunders, W. W. Moore. 

Wisconsin — Drs. E. J. Zeigler, F. Pinch, J. E. Marsh, Ed. Piichner. 

Indiana — Drs. M. L. UumstoB, Jno. J. Thompson. 

Dakot.v— Drs. A. D. Brown ($3.00), J. H. McGhee, J. L. Otlerman. 

OuKGON — Dr. J. F. Grimm. 

KEXTrcKT— Drs. Thos. C. McCarty, W. W. Lami)uth,II. Tngg. 

Minnesota— Dr. E.C. Gile ($2.00). 



Keadiiig' Notice. 

Bowman's Koumis.s is considered by the physicians of Peoria and 
wherever used, to be the finest preparation of the kind made. Read the 
article on Koumi.s.s in this number, then turn to Bowman & Co's. page, 
and ilufit order some for tlie patient needing it. 



The Peoria 
MEDICAL MONTHLY. 



Vol. V. SEPTEMBER, 1884. No. 5. 



(Driginal ^ommuntattonsi. 



Art. I — Electro Therapeutics. By Romaine J. Curtiss, M. D. Joliet, Illinois, 
Professor of Hygiene and State Medicine College of Physicians and Sur- 
geons, Chicago. 

MACHINES AND SOME GENERAL PRINCIPLES. 

Some time ago I contributed a series of clinical reports 
on the practical use of electricity in disease to this 
journal, which met with so little criticism which disturbed 
nie, or did not instruct me, that I am disposed to offer a 
few more short papers of the same character. In former 
papers I said nothing about machines, which fact brought 
me many letters, making inquiries in this direction. I will 
now say something on the subject, and refer briefly to 
some of the general principles of electricity in relation to 
therapeutics. 

The terms usually employed to designate different 
kinds of electricity as used in therapeutics, such as gal- 
vanism and Faradism, and Frankliuism, do not of course 
throw any light on the nature of the currents, respectively. 
There are other names for the different kinds of machines 
and electricity; thus galvanism is called the constant cur- 
rent, Faradism the induced current, and Frankliuism the 
static current or static electricity. 

Different kinds of machines are used to generate these 
different kinds of electricity. The galvanic or constant 



270 The Peoria Medical Monthly. 

current, is generated by chemical action, or by convertive 
chemical force into electric force. The characteristic of 
this kind of electricity is, that it is of large quantity and 
low intensity. It is like a large river, flowing through a 
level country very slowly, because of the little fall there 
is, or because its "profile" is so nearly level. 

The characteristic of Faradic and Franklinic or induced 
and static electricity is, that it is of high intensity and i& 
correspondingly less in quantity. It is like a mountain 
stream, which, while it is not so large in quantity as the 
slow moving river, it is extremely active. Now, we can't 
exactly say that because a mountain stream is useful for 
turning water wheels, and the large river is good for 
navigation, that there are equal differences in the uses of 
the galvanic and induced currents; but there is, however, 
a great difference between them, and the differences will 
probably widen, as knowledge on the subject increases. 

The rule is that all galvanic machines give large quan- 
tities and low intensity^ or ought to. Of course different 
machines vary in this respect. The law is that the quan- 
tity corresponds with the number of cells, and to have a 
battery, giving a large quantity, with low intensity, the 
chemical action must not be violent or the number of cells 
large. Accessories, which are attached to galvanic ma- 
chines, vary the quantity and intensity of the current. 

In all other machines the rule is that the quantity is 
small and the intensity high, and this embraces the electro- 
magnetic, magneto-electric, and static machines. 

I will note first the difference between electro-mag- 
netic aud magneto-electric machines in relation to their 
currents. It was found, by making experiments, that if a 
coil of wire was approached toward a magnet, or a magnet 
brought up toward a coil of wire; for instance if a person 
holds a coil of wire in one hand and a magnet in the other 
and brings them together or causes them to come near 
together, the magnet will cause a current of electricity to 
pass through the wire in one direction, and as the coil and 
magnet are separated again it will cause a current to pass 
through the wire in another direction. 



Original Communications. 271 

When a current of galvanism is passed through a steel 
wire it converts the wire into a steel wire magnet just as 
long as the current continues to pass. When the current 
stops the wire ceases to be a magnet. 

These two principles enable us to explain the action of 
the two kinds of machines which both generate the same 
kind of current of small quantity and high intensity. In 
the magneto-electric machine there is a large magnet, and 
one or more coils of wire or spools ot wire attached to a 
wheel. Turning the wheel brings the coils of wire toward 
the magnet in part of the wheel's circuit, and increases the 
distance between them in another part of the wheel's 
circuit; and this motion, filling the conditions required 
just the same as when a person holds them one in each 
hand and brings them near together and separates them, a 
to and fro current is generated by the magneto-electric 
machine, if other things are equal, whenever the crank of 
the machine is turned. 

In the other, or electro-magnetic machine the other 
principle is employed, viz: That if a current of galvanism 
is passed through a coil of wire, the wire becomes a magnet; 
but the wire is no longer a magnet when the current stops. 
An electro-magnetic machine then is made of a galvanic 
cell for generating a current. There is also a coil of wire 
(in helix) and an arrangement for breaking the circuit, or 
starting and stopping the circuit in its passage through the 
coil of wire. This end is accomplished by a vibrating 
spring. When the spring is at one end of its travels it 
makes connection with the circuit of galvanism, which 
can then pass through the wire. During this time the 
little hammer is farthest from the helix or wire coil. As 
soon as the current again parses, the wire, or helix, becomes 
a magnet, and by pulling the hammer to itself (magnets 
attract steel) this action pulls the spring away from its 
other attachments which breaks the circuit and the current 
stops. As any one knows who has watched, or felt the 
process, this action of breaking the circuit, magnetizing the 
coil, stopping and starting the current through the wire 
and demagnetizing the coil, is accomplished with great 



272 The Peoria Medical Monthly. 

rapidity, the whole process being repeated and fully 
accomplished with every complete swing of the spring 
hammer. 

The static machines are sometimes called frictional or 
Franklinic, because the current is generated by the mechan- 
ical force of friction. Moleclular force is first evolved 
which is converted into a high tension electricity. These 
frictional machines are not used in medicine however, — 
at least the old fashioned kind, made of a sealing wax 
cylinder and silk so arranged that there is friction between 
the silk and cylinder when the crank is turned. The 
machines now used are modifications of the Holtz appa- 
ratus and made of a stationary and revolving glass plates. 
The revolving plate carries metal disks which, in motion, 
strike against metal brushes, which action generates the 
current. Near the brushes are situated combs, so-called, 
having metal teeth, which attract the current and carry it 
into small leyden jars. The connections are made in such 
a manner that the amount of the charge in the jars can be 
governed, and the discharges can be regulated with such 
accuracy, that the current differs, in some particulars, very 
little from the induced currents, except that it is less in 
quantity, and more intense. If galvanism is like a large 
river, flowing through a level country, and induced 
electricity is like a mountain stream, then the static 
current or static induced current, as it is called, is like a 
cascade. 

The static machine combines the i^rinciples of both 
induction and friction, in its action. The friction between 
the metal disks and brushes is very slight, and often when 
the machine is charged, or the current started, the brushes 
can be drawn away until the:^ do not touch the disks or 
cause any friction without stopping the current. 

This gives an outline of the general principles and 
actions of the machines used in medicine, and the currents 
they use. For cautery a machine which generates a large 
quantity ot high intensity electricity is employed, when, by 
passing the current through a platinum wire, which has 
considerable resistance, the wire is made hot l)y the heat 



Okiginal Communications. 273 

force which is generated by its correlation with electricity, 
or by converting electricity into heat by means of the 
resistance of the platinum. 

It does not follow that machines are not constructed 
which give large quantity with high intensity. We may 
have a large river forming rapids, or a water fall, as 
Niagara; but such is not the rule. Magneto-electric, or 
dynamo machines, are made which generate large quanti- 
ties of electricity, having high intensity. The machines 
which are used for electric lights are of this character, but 
as used in medicine, the machines are constructed to give 
us the widest variation possible in the character of the 
current, as well as therapeutical effects, and hence we have 
the machines which give currents of large quantity and 
low intensity, and others giving small quantity and high 
intensity; and in practical use we find that all the differ- 
ent effects, which we get from electricity, in therapeutics, 
can be attributed either as effects of large quantity or low 
intensity, and we do not need any other distinctive titles 
to express any kind of electrical current, and all the 
different kinds of electricity as galvanic, static, dynamic, 
electro-magnetic, magneto-electric, Franklinic, Faradic, 
friction al or what not, are either large quantity with low 
intensity, or high intensity with small quantity. There is 
no known difference but this between any manifestations 
of electrical action or condition, not even between what 
we call negative and positive electricity. 

This latter proposition needs a little further explana- 
tion, and I will endeavor to give it from the standpoint of 
our machines. I do not know, or remember, what the text 
books say is the difference between positive and negative 
poles or currents, but am going to say what I think about 
it anyhow, and what I think is just what I have said, that 
the only difference between positive and negative is one of 
intensity and quantity. This was first suggested to me by 
watching my static machine running in a dark room. I 
always notice that the comb on one side of the machine, 
either one side or the other, takes up more electricity from 
the glass plate than its opposite. If the machine gets a 



274 The Peoria Medical Monthly. 

little darap, so that it works with difficulty, I can see that, 
gradually, after a few miuutes, perhaps, the appearance of 
quautit}' on the two sides, or the two combs are nearer 
ecjual. In a minute more, perhaps, they will be precisely 
equal, so far as can be judged by sight, when the discharge 
from the jars will stop. In a moment more there is a 
change, and the comb on the other side is taking up the 
greater quantity, as is plainly visible, and the discharge 
from the jars begins again. I have watched this change 
when the machine was dampand have seen it occur oftener 
and oftener until the current ceased. 

In a dark room, with the machine in good order, it is 
always noticeable that either on one side or the other there 
is visible a larger quantity of electricity than the other. 

Xow, when we investigate our electro-magnetic and 
galvanic machines we find them all duplicated, so to speak. 
The same is true with the static, and also with the dyna- 
mic. In the galvanic cell there are two factors to the 
battery element, one is zinc, perhaps, and the other copper. 
It is always the case that the acid of the battery fluid has 
a greater affinity for one of these metal factors than the 
other. If you take two plates of zinc and make a battery 
of them, you will get the same chemical action but no 
manifestation of electricity; but if you change one for 
copper or carbon, the acid does not act upon them equally, 
and electricity, differing in quantity and intensity, is 
formed, the positive or less quantity, at the plate upon 
which the acid has the most feeble action. 

In the magneto-electric, the action which generates the 
current, is also double — the motion toward each other of 
the coil and magnet and the opposite motion. These 
motions, opposite in character, differ in their power to 
create a current, and hence the manifestation. 

There is no light thrown on the subject of electro- 
therapeutics by saying that galvanism has such an effect 
over pain or the integrity of tissues, or as an antagonist of 
other symptoms, for sometimes the galvanism may be 
taken from a machine which has so high intensity, that, 
though it is galvanism, it has a very different effect from 



Original Communications. 275 

low intensity galvanism, and the same law is true with 
other machines. A little electro-magnetic machine, or a 
small leyden jar discharges a current of high intensity, 
which produces very detinite therapeutical effects; but a 
machine can be constructed which will generate a current 
of no greater intensity than this, but with an immense 
quantity with the same intensity, and the effect will be 
very different. The dynamos used for running electric 
lights are types of large quantity and high intensity. 

Our practical distinctions then, between the different 
currents and machines, as well as between positive and 
negative, is simply a distinction between quantity and 
intensity. 

The questions come up, of course what is electricity, 
anyhow? and we can briefly answer by the statement that 
electricity is a force. We can prove this by our machines. 
We acknowledge, of course, a modern scientific general- 
ization, that one kind of force can be changed into any 
other kind. (I always add by the resistance of some kind 
of machine). A good definition of a machine is that it is 
matter so arranged that forces can't get through it without 
being changed from one form of manifestation to another. 
Our electric machines are so built that they can change 
chemical action, or mechanical force into electricity. 
Machines are made to change, not only chemical force, but 
heat and light into electricity. When a man turns a 
static or a dymanic machine with his hand, the force of 
his muscles is sent into the machine, but the machine is 
so arranged that this force can't get through the machine, 
unless it is converted, in its passage, into electricity. 
Galvanic machines and electro-magnetic machines, are so 
constructed that chemical force can't get through them 
without being first converted into electricity. Machines 
which we use, then, do not manufacture electricity for us, 
in the senses of creating it out of nothing. To get force 
out of these we 'are obliged to put an equal amount of 
force of some other kind into them; and if they are in 
good order, they will do the work of converting the forces 
into electricity. 



276 The Peoria Medical Monthly. 

Now for practical use, a doctor wants a machine for 
furnishing a large quantity current with low intensity, and 
another machine for high intensity, and small quantity. 
As these two qualities are almost opposite each other in 
effects, therapeuticalh^, the machines are best which go to 
the extremes. One machine should give a very large 
quality with very low intensity, and the other very high 
intensity and very low quality. A galvanic machine w^ith 
one hundred cells, arranged with a rheotome to diminish 
the intensitj', is what is needed for one, and a static is the 
machine for the other. Now a sort of medium between 
these two is the electro-magnetic, and the magneto-electric 
machines. I think the day of electro-magnetics has gone 
by. or ought to. The first cost is to large and they are 
always getting out of order, and costing more. The little 
dynamos are cheap, and will do everything that the electro- 
magnetics will. It some good genius will design and con- 
struct a neat little dynamo which will run thirty minutes 
with a spring, he will make some money and get great 
honor, and the gratitude of the profession. 

In my next paper I will describe the method of using 
the static machine, with cases. 



AuT. II— Scarlatina. By Wm. H. Veatch, M. D., Carthage, III. 

As the season approaches in which we may expect the 
appearance of the Febres Exanthematica, it may not be 
wholly unprofitable to consider the most fatal of all that 
class of diseases which we term exanthamatous, par- 
ticularly some of its rarer forms and complications. 

There is perhaps no disease with which we have to 
contend, so remarkable for its grent diversity of symptoms 
and uncertainty in results as the one now before us. 

"In its simple form it is not an object of any degree of 
solicitude, except in its relation to those surrounding it, 
or in its communicability to those who come in contact 
with it; but in its severer forms there are few diseases 
more to be dreaded or more properly termed malignant." 
(Flint.) 



Original Communications. 277 

Three varieties are usually recognized by authors, the 
symptoms of which are widely different as regards severity 
or intensity, but these three varieties are understood to be 
one and the same disease. 

The vague popular notion, well nigh universal with 
the laity, that scarlet rash and scarlet fever are separate 
and distinct diseases, is unquestionably the result of false 
teaching on the part of a large proportion of the medical 
profession, and the sooner this false notion is corrected the 
better it will be for the profession and the world. 

The Doctor says: "It is only scarlet rash and is of no 
consequence," is a very common expression among the 
people m response to the anxious inquiries of their neigh- 
bors, when a suspicious and unaccountable case occurs in 
the community. 

The first case is usually a mild one and as soon as it is 
known that the doctor says it is only scarlet rash, the 
people have no alarm until perhaps dozens of cases are 
infected, from which arise a number of malignant ones and 
several deaths occur. I say all this the profession is 
responsible for. 

The many undeniable demonstrations of the identity 
of the various forms of the disease should teach us to warn 
every family that the mildest case of scarlatina simplex 
may be followed by an epidemic of the severest form of 
scarlatina maligna. 

"The anatomical characters of scarlatina are unim- 
portant -aside from the eruption and the throat affection. 
The lesions in other situations of the body are due to com- 
plications." (Flint.) But it being my purpose to speak 
more particularly of some of . the more rare forms and 
complications of the disease, I shall not attempt to follow 
its ordinary manifestations but notice some late views 
expressed by a few writers of note on its diagnostic and 
pathogenetic characteristics. 

Various notions have at different times been pro- 
mulgated in regard to the nature of the^disease and the 
manner of its being communicated from one person to 
another. The prevalent idea has been that a miasma of a 



278 The Peoria Medical Monthly. 

specific and peculiarly infectious character arises from the 
patient from the beginning to the end of the disease, which 
being inhaled by a susceptable person, reproduces its like; 
that the miasma is capable of retaining its infectious 
nature for an indefinite length of time, under circumstances 
favorable to its preservation. Thus we hear of the disease 
being carried great distances in the clothing of physicians, 
nurses and even patients themselves whose clothing has 
not been properly cleansed before going abroad. Numerous 
instances are on record where the supposed miasma has 
been retained in houses that have been vacated and closed 
for months, and then infecting the first occupants who 
unsuspectingly took possession. This pathogenetic enigma 
has puzzled the brains of some of our most zealous investi- 
gators. 

Only a short time has elapsed since a new light burst 
upon the previously clouded vision of the scientific world 
which promises to dispel the darkness in which it has been 
for centuries. 

The theory of specific germs has been troubling the 
waters of scientific investigation for some time, and at 
length a Berlin investigator (Pincus) has made the astound- 
ing announcement that he has discovered minute micro- 
cocci manifesting their presence first in the epidermal 
cells, where myriads of minute point-like bodies have been 
found at work under the epidermal scales. These he 
regards as pathogenetic, the prime cause of the origin of 
the disease. 

The germ theory has been advocated by numerous 
investigators, but none, to my mind have brought their 
investigations to the point of absolute demonstration as 
clearly as has this investigator. 

The many outbreaks of this disease which cannot be 
traced to a known origin, may be explained on this theory, 
while on the miasmatic theory they cannot be satisfactorily 
accounted for. 

If time an4 experience should prove this theory to be 
correct it certainly will prove to be a wonderful diagnostic 
benefit both to the profession and to the world. 



Original Communications. 279 

Many of the first symptoms of scarlet fever are also 
symptoms of a variety of other diseases: the headache, 
general lassitude, vomiting, early delirium, the enlargement 
of the lymphatics about the jaw, and the redness of the 
fauces are all symptoms of other forms of disease, and are 
not sufficient in themselves to predicate a positive diagnosis 
upon; and yet the welfare of the patient and the com- 
munity demands an early diagnosis. These symptoms in 
connection with a persistent high temperature usually 
point to scarlet fever, and yet we dare not say scarlet 
fever in a first case, during the first twenty-four hours, or 
until the eruption makes its appearance. 

Again, we may have scarlatina almost without febrile 
movement, without perceptible rash, without angina, and 
in a first case our thoughts never be directed to scarlatina, 
until the startling fact is thrust upon us by an outbreak of 
the disease in the family or perchance the whole com- 
munity. 

"Difficulties of diagnosis in first cases may present 
themselves in either of the three stages, in the initial stage 
measles, diphtheria, small pox or catarrhal fever, pneu- 
monia or even quinsy may give us trouble to differentiate. 
In the eruptive stage measles, erj^thema, roseola or even 
urticaria may set up their claims of consideration. 

In the desquamative stage it may be necessary to con- 
sider all the symptoms, surroundings and history ot the 
case, and then diagnose by exclusion, and yet a certain 
percentage of cases will remain of doubtful character." 

Now, if it be true that each and every case of scarlet 
fever is the direct result oi the invasion of the skin by 
these minute differential micrococci or germs, our special 
diagnosis will not oi>ly be aided, but we may reduce the 
matter to a positive certaintj^ and many so-called epidemics 
of scarlatina may be wholly averted. It is to be hoped that 
other observers will take the matter in hand and soon give 
to the' profession, not only a true and never failing 
diagnostic standard, but may it not be hoped that the 
nature of the disease may be so amply demonstrated that 
it may become entirely preventable. 



2S0 The Peoria Medical Monthly. 

Directlj^ in this line of thought comes the observations 
of Dr. J. P. Walker, of Mason City, who, in 1854, claimed 
to* have discovered by absolute experiment, that scarlet 
fever was wholly propagated by the furfuraceous desquam- 
ation of the skin and in no other way. 

In 1875, he presented to the State Medical Society his 
experience with the old German plan of treating the 
disease by inunction. Not only as curative, but as a 
preventive of the further spread of the disease, holding that 
when desquamation occurred, the nuguent being of too 
great specific gravity to float in the atmosphere, thus pre- 
vents the spread of the disease. These thoughts may 
prove of more value to the scientific world than the Doctor 
has had credit for, if it be fully demonstrated that Pincus 
and his disciples are correct. 

Dr. Silas Hubbard, of Hudson, 111., says that he has 
practiced inunction in scarlet fever for thirty five years, 
and further states that in his brain originated the supposi- 
tion that scarlet fever is an attack of millions ot parasites 
on the skin of the subject, and to combat them he greased 
the patient, and that those around did not take the 
disease or had it very lightly. 

Dr. Merrill of South Carolina, in 1848 or 1849, wrote 
an article on this subject, in which he claimed that the 
fever spent itself on the grease upon the skin instead of on 
the fats of the body. Thus we find that this germ theory 
was acted upon many years before its demonstration. 

I find myself drifting toward the treatment of the 
disease, which I did not intend to touch in this paper. So 
if I may be pardoned for this slight digression I will pro- 
ceed to consider some of the most common and also the 
most fatal complications of the disease. 

We hear of late a great deal said of the relationship 
existing between scarlatina and diphtheria. In the old 
world I think we may find more amalgamationists than we 
have in this country. In the British Medical Journal 
Drs. Parsons, Power and Bond, who it is claimed have had 
unusual opportunities of observing the nature of these 
affections, all seem to hold to the doctrine of a sameness of 



Original Communications. 281 

origin. These observers cite numerous instances in which 
the two diseases have been so closely associated that one 
appeared to depend for its existence on the pre-existence 
of the other. 

Now these and other observers appear to never have 
severed their connection with that old and oft exploded 
sophism, that two poisons cannot exist in the vital economy 
at one and the same time, producing each its specific effect. 
But if I may be allowed to offer a few thoughts on this old 
and threadbare subject I will try and harmonize this 
conflict of ideas. We may readily conceive of two causes 
being brought to bear on the system at one and the same 
time, either affecting the same, or different sets of organs, 
and each maj^ produce its speciflc effects, these effects 
being either modified or intensified by the presence of the 
other. Thus we see in typho-malarial fever, the causes are 
as distinct as light and darkness, the one being an idio, and 
the other a koino miasmata; one, the product of the decay 
of animal matter, and the other the product of the decay 
of vegetable matter. When these causes are brought to 
• bear on the animal economy at the same time, and each 
producing its specific effect, we have as a product a 
dualistic form of disease, as every practitioner in the land 
can testify. 

The simple fact of the co-existence of two diseases does 
not prove their identity of origin, and in this case as in 
many others, stubborn facts have upset the profound 
theories of wild speculators. With Gregory, of St. Louis, 
we are made to exclaim, '"an ounce of well authenticated 
facts is worth many tons of theory."' 

But I must hasten to the consideration of another dual 
form of this affection; one upon which there has been but 
little written, because there has been but little to write 
about, it being perhaps the rarest complication we have to 
contend with. I have reference to what Dr. Samuel C. 
Busey, of Washington, D. C, has been pleased to call 
Scarlatina Puerperalis. 

This high sounding appellation appears to embrace all 
cases of scarlatinal disease occurring in child-bed, modify- 



282 The Peoria Medical Monthly. 

iucr or intensifying the S3anptoms occumng in that state. 

We find two distinct opinions being set forth by 
observers on this subject, each having its respective cham- 
pions: there is being more written on the subject to-day 
thaii at any former period. The advocates of one theory 
hold that it is true puerperal fever, in which the scarlatinal 
poison has been added to the pyemic or septicemic condi- 
tions intensifying the gravity of the case; while the other 
school teaches that it is only scarlet fever attacking a 
lying-in woman and doos not depend on pyemia or 
septicemia for its support. These two views are being 
pushed to the front by their respective champions, and 
cases are being collected by each to establish and verify 
their respective theories. 

The only case of the kind I have ever met was a very 
striking one and one I will ever remember with feelings of 
1 egret. This case made an impression on me which can 
never be erased from the tablets of my memory. 

In my early practice, I was called to attend a lady of 
high intellectual and social rank, in her first confinement. 
I had the same day been in attendence on a family of child- " 
ren with malignant scarlatina in the eruptive and desqua- 
mative stages. It being cold weather and extremely high 
winds blowing, I had no thought of conveying the dreadful 
malady to my lying-in patient, particularly as I had to ride 
five miles before reaching her home. Her labor was a 
normal one, rather tedious, terminating in about twenty 
hours after my arrival. Everything went smoothly until 
the beginning of the third day, when she had a severe 
chill, followed by extremely high temperature, sore throat, 
suppression of the lochia, tenderness and swelling of the 
abdomen, wild delerium, etc. The next day, the second of 
the fever, and the fourth after her confinement, a profuse 
scalatinal eruption covered the whole surface, head, trunk, 
and limbs; also all the symptoms of septicunic poisoning. 
On the eighth day of the fever, when desquamation was 
almost complete and the true skin yet thickened and as 
red as a piece of red flannel, she collapsed and and died, 
never having returned to consciousness. 



Original Communications. 283 

This case gave me much anxious thought, and I always 
regarded it as a case of true malignant scarlatina., con- 
ve3'ed to the patient by my own hand to the vaginal mucos 
membrane, the inflamation of which caused a suppression 
of the lochia, and consequent septicemia; but the scarla- 
tina, although accompanying the puerperal fever, did not 
depend on the septicemic condition for its support, but 
accompanied by it was greatly intensified, and wonderfully 
complicated the case. I hope I shall never be permitted 
to see another such. Other complications occur with this 
disease which I regard in the same light as I have consid- 
ered the foregoing, such as rotheln, rubeola, urticaria and 
herpes zoster, each being a specific disease produced by a 
specific cause, but when complicating scarlatina greatly 
intensify the symptoms. 

In the past two years there have been a great many 
heated discussions in this county over the complication of 
this affection, and in some cases much bad blood has been 
generated among physicians, on account of the conflicting 
opinions expressed. Some calling the cases Scarlatina and 
therafter would not relinquish the claim first set up. 
Others first said Rubeola, and for fear of being called fickle 
would stick to it. Others again would say Rotheln and 
hang on with an equal tenacity. I think that in the mass 
of cases they were all right and all wrong, for the great 
mass of the cases coming under my observation were com- 
plications. And this is the only view we can take of the 
cases occuring in this county and reconcile the cases with 
their history and symptoms. 



Art. Ill — Violent Spasmodic or Gradual Aspiratory Movements of the Uterus 
During the Female Orgasm — AVhicli? By M. D. 

[Note — In accordance with the desire of the author of this paper, we have consented to 
transgress a rule and publish it without a name. We certainly would not do this if we did not 
personally know the writer and be able to fully vouch for both his professional and personal 
reputation. His statements can be relied upon. — Editor.] 

Does the uterus take any active part in the act of 
copulation, or is it merely a passive recepticle for migra- 
tory spermatozoa in their blind hunt after the ovule, is a 
question of comparatively modern date, although by the 



284 The Peoeia Medical Monthly. 

observations of several writers and more minute anatomi- 
cal investigation the question has really been narrowed 
down to one, viz: as to the character of the uterine move- 
ments, as expressed by the title given to this article. 

From the structure of the uterine tissues and more 
especially those of the cervix, as well as the complex 
arrangement of the uterine vessels, it was argued that the 
uterus did possess true erectile properties, analogous to 
those of the penis, sometime before any recorded observa- 
tions of actual occurences added weight to the theory. In 
1846, Litzman recorded that during the vaginal (probably 
digital) examinatioQ of an erethistic girl "the uterus 
assumed a more perpendicular position, was drawn more 
deeply into the pelvis, the lips of the os uteri became 
separated, the os became rounded, softer and more acces- 
sible." 

In 1859, Eichstedt announced his belief in the aspira- 
tory movements of the uterus during coition, but whether 
or not he recorded any facts in proof of his theory is 
unknown to the wa-iter. Others followed, and in 1872, Dr. 
Joseph R. Beck, {St. Louis Medical and Surgical Journal 
1872,) gave the strongest proofs of the spasmodic action of 
the uterus that had yet been adduced, and, in fact, they 
remain about the only proofs that have been ottered in 
substantiation of the spasmodic theory. Dr. Beck's paper 
is doubtless familiar to all of my readers, so I will only give 
that part that is ot present interest. In examining a 
woman of passionate nature he produced an orgasm by 
digital means, of which he says: The os and cervix uteri 
had been hard, firm and generally in a normal condition 
with the OS so closed as not to admit the uterine probe 
without difficulty; but immediately the os opened to the 
extent of fully an inch, made five or six successive gasps, 
drawing the external os into the cervix each time power- 
fully, and at the same time becoming quite soft to the 
touch." 

Other writers besides those mentioned above, notably 
Drs. Munde,^ Peters,^ McCully"^ and others have since verified 

1 Amcrioaii Joiirnul of Obstctricjs, AuKiist, 1883. 

2 American Journal of ObMtelrirw, August, 1884. 

3 Ainerifjan Journal of OljHtetricM, AugUMt, 1883. 



Original Communications. 285 

to a certain extent the statements of Dr. Beck, although in 
none of their cases did the uterus exhibit the decided 
spasmodic action as described by him. 

Dr. Peters has observed "the hardening and elongation 
of the cervix; the sinking ot the uterus downward towards 
the vaginal orifice; the moderate yet distinct enlargement 
of the OS uteri," in many cases. He takes side with those 
who affirm the slow aspiratory movements of the uterus, 
as will be shown by the following: 

"One point 1 wish to iterate, founded upon my 
repeated observations, viz: that the aspiratory movements 
of the uterus are not spasmodic but are comparatively slow 
and gradual, and I doubt not very powerful. I am aware 
that Dr. Beck's case stands o'pposed in a certain sense to 
this theory, and yet perhaps not really, inasmuch as the 
gradual aspiratory movements may have continued after 
the spasmodic action had ceased in his case." 

All these facts and theories are only important in so 
far as they assist in deciding the question, how do sperma- 
tozoa enter the uterus? which now seems variously 
accounted for on three different theories, viz: 

1. The old theory of the migration of the spermatozoa. 

2. That advanced by Dr. Beck, that during coitus the 
€S uteri spasmodically opens, thus permitting of the 
iufc mediate ejaculation of the impregnating fluid directly 
into the uterine cavity. 

3. That entertained by Dr. Peters and others, that 
there is a gradual aspiration by the uterus of the contents 
of the vagina immediately surrounding the os. 

The first of these theories does not enter into the 
subject of this paper, and in fact is now entertained by 
very few if any. 

The question is thus narrowed down to my title, and 
can only be settled by further evidence on one side or the 
other. 

Dr. Peters states that the violent spasmodic action as 
described by Beck, has not been noticed by any other 
observer, from which the inference may be drawn that he 



286 The Peoria Medical Monthly. 

considers Beck's case an unique one and without further 
support. 

It is with the view of substantiating the observations 
of Dr. Beck, and possibly adding to the strength of the 
second of the above-mentioned theories, that this paper 
was written. It is needless to say that these statements 
are not made without hesitation, and fear of being consid- 
ered vulgar and obscene ; yet I believe that all facts that 
relate to medical questions should, so far as possible, be 
given to the profession for the general weal. 

Without further explanation I will record the results 
of my own observations on the subject. 

During coitus, I can always experience the sensation 
of the resistance of a hard substance, w^hich I know to be 
the womb. When connection takes place after prolonged 
absence, prolonged continuance, or after a menstrual epochs 
w^hen the female erethism is naturally heightened, I have 
repeatedlji, just at the occurence of the orgasm, felt this hard 
resisting bodg, (the cervix), become softer and spasmodicalUj 
open and grasp the glans penis to the depth of certainly half an 
inch, and in its Jull circumference. This occurs several 
times, proportioned to the sexual excitement existing, and 
within a few seconds, five or ten, the cervix is hard and 
presents the usual resistance. Digital examination made 
as quickly after the orgasm as possible reveals precisely the 
same effects as those mentioned by Dr. Beck. 

My wife tells me that during coitus, when the sexual 
nature is not aroused to its full extent, she experiences 
only the usual pleasurable sensations of the act, but at 
such times as I have above alluded to, there is a marked 
increase in the quality of these sensations, with an added 
one, that of drawing up or inspiring effort of something 
deep in the pelvis, which she supposes to be the womb, 
lasting but a few seconds. 

Whether these facts have been noted by other medical 
men (more modest than I), is, of course, unknown to me, 
as no record of it has been made, but several men, not 
medical, with whom I have conversed, tell me of sensa- 
tions precisely similar. One expressed it "that the glans 



Our Clinical Society. 287 

seemed to enter the neck of a rubber bottle." The related 
experience of several women coincides with that of my 
wife as related above. 

Let us hear from others on the subject now that the 
ice is broken. 



CDttf (Slittial ^mti^» 



[For this department we hope to enlist the co-operation of our friends. Short reports of 
interesting cases are especially requested from every one. We would like to have twenty or 
more such articles for each number. See editorial in No. 1, Vol. V, May, 1884.1 

Art. IV— Two Cases of Cancer of Stomach. By L. L. Leeds, M. D., Lincoln, 

Illinois. 

The following cases will serve to illustrate the great 
difficulty in correctly diagnosticating the exact location of 
cancer of the stomach or other internal viscera. 

Case No. 1— Mrs. R., a German lady aged 55, always 
enjoyed good health until in the tall of 1879, when she 
began suffering with symptoms of indigestion for which 
she was treated without much benefit. These symptoms 
continued with occasional intervals ot apparent improve- 
ment and relief, during which she rapidly regained flesh. 
The chief symptom was vomiting without pain or retching 
of food of every kind, which returned unchanged from its 
condition when taken. In 1S80 she visited the Hot Springs 
in Arkansas, and for a time experienced some relief, but 
the inability to retain food recurring, emaciation was slow 
but continuous. In October, 1880, 1 saw her for the first 
time, found her complaining of the above symptoms. No 
pain or tenderness over region of stomach and uo symptoms 
referable to other organs. Great longing for all kinds of 
food; taste unimpaired; no difficulty in swallowing, but 
food not retained longer than five minutes. Nothing 
peculiar in appearance except the emaciation due to lack 
of food. Symptoms continued without material change 
till within 72 hours of death, when some pain in epigas- 
trium was felt, and there was frequent vomiting of a very 
fetid coffee-ground like fluid with one or two small passages 
from the bowels of similar character. A slight tumor in 



288 The Peoria Medical Monthly. 

the epigastrium was indistinctly felt on deep pressure two 
days previous to death, which occurred August 30, 1881. 
Eighteen hours after death a post mortem was made by 
Dr. Katharine Miller and myself; making an incision from 
eusiform cartilage to umbilicus and transversely between 
cartilages of ninth ribs, fount! abdominal walls thin; 
very little adipose; intestines empty but normal in appear- 
ance; liver normal. In attempting to raise the stomach 
found it adherent above and behind at cardiac extremity 
to neighboring structures. With some difficulty succeeded 
in passing a ligature about the sespohagus it being neces- 
sary to wound the diaphragm in order to accomplish this. 
Then cut the a3Sophagus and dissected it and the adjoining 
part of the stomach from the crura of the diajDhragm and 
adjacent structures to which they were firmly adherent. 
The spleen was also slightly adhered to the stomach. On 
opening the stomach it contained about a pint of very fetid 
grumous fluid. The lower part of the gesophagus li to 2 
inches in length was thoroughly infiltrated, indurated and 
thickened, while folds projected into the calibre closing it 
completely. The cardiac portion of the stomach within a 
radius of two inches from the cardiac orifice was in a 
similar thickened and indurated condition. The remamder 
of the stomach appeared normal. There was a small 
nodule of indurated tissue apparently connected with the 
mesentery quite Iqw down. 

Case No. 2 — Mrs. S., a German lady aged 694- years, 
began suffering with symptoms of indigestion with some 
(but not much) pain in the epigastrium about May, 1883, 
she informed me that these symptoms continued with 
varying severity, but gradually increasing persistency until 
July 9, 1884, when I first saw her. Then she complained 
of some pain, very slight, in the region of the stomach, 
with frequent vomiting occurring soon after taking food. 
Howels move by aid of injection; no tumor perceptible in 
epigastrium or elsewhere. After July 18, no pain or 
soreness in epigastrium, but vomiting continued unabated. 
Solid or liquid food returned nearly or (juite unchanged in 
a few minutes after swallowing. Vomiting painless unless 



Our Clinical Society. 289 

when prolonged, when some uneasiness was felt from the 
straining of abdominal muscles. About six days prior to 
death the vomited matter became dark and had a peculiar 
cadaveric odor which continued until death, which occurred 
August 8. Seven hours after death Dr. Katharine Miller 
and myself made a post mortem examination. On opening 
the abdomen found the extremely distended stomach 
covering and concealing all the other viscera, extending 
from sternum to pubis and live to six inches in transverse 
diameter. The pylorus dragged down and lying in full 
view. Gall bladder much distended, otherwise normal. 
Liver pancreas, spleen and intestines normal. Colon 
empty. Pelvis and cul-de-sac ot Douglas filled with small 
intestines. Removed the stomach which contained about 
five pints of dark ill smelling fluid. Walls at cardia very 
thin, vessels show very plainly all over the surface. 
Mucous membrane smooth and velvety covered with thick 
mucus, very tenacious along lesser curve and about pylorus-. 
Many submucous hemorrhages along greater curvature and 
about pylorus, and freshly ruptured capillaries along lower 
side of pylorus. Pylorus greatly contracted, with difficulty 
the finger could be pressed through the irregular and 
crooked passage. Infiltration greatest at lower side of 
pylorus, but extending entirely around. A cicatricial^ap- 
parently) contraction and infiltration existed on the serous 
surface, near but not encroaching on cardiac orifice. 
Stomach measured 19 inches along greater curvature, and 
13 inches in circumference in smallest diameter. 

These cases will illustrate the difficulty, often extreme, 
in diagnosticating the existence of cancer rather than other 
gastric or visceral disturbance, and also the still greater 
difficulty of positively locating the disease. The peculiar 
pain of visceral cancer is supposed to be one of the most 
constant symptoms. Yet in both of these cases no severe 
pain was felt. In the former no pain was noticed until 
within a few hours of death. In the latter the moderate 
pain which had occasionally occurred, entirely ceased three 
weeks before death. In both the most marked symptom 
was the prompt and persistent rejection of food and drink 



290 The Peoria Medical Monthly. 

uuchauged by digestion. Both suffered from hunger and 
thirst and ate and drank with keen enjoyment. Both 
vomited without retching and in neither did the vomiting 
cause pain, except when so frequently repeated as to strain 
the abdominal muscles. 

In the former case the symptoms were so obscure that 
only a few days before death the disease was diagnosticated 
as paralysis of the esophagus by a physician of good 
judgment and wide experience. With symptoms so nearly 
identical I confess the post mortem examination in the 
latter case was a surprise, showing a condition so com- 
pletely the reverse of the former. In the one the stomach 
was normal in size and only partially full, the rugae of the 
mucous membrane prominent, the general surface perfectly 
normal. In the other the stomach was enormously dilated 
and filled with a great amount of tenacious mucus and 
grumus fluid, the walls very much thinned, especially at 
the cardia, the rugae of the mucous membrane obliterated 
and the general surface showing marked indications of 
chronic congestion. 

In neither case was there a previous history of heredi- 
tary tendency or ot any of the usually ascribed causes of 
cancer. 



Art. v.— Tetanus Nascentiiim. By W. H. Reedy, M. D., Towanda, 111. 

In view of the statement made by Meiggs & Pepper, in 
their revised work on the "Diseases of Children," on the 
above subject, under the head of Prognosis, viz.: that "the 
majority of authors state that they have never met with a 
case of recovery from fully established 'tetanus nascentium,'" 
and believing in a theory of causation, and consequently 
of treatment, which these and most other authors, so far 
as 1 am aware, practically ignore, I venture to lay before 
y<jur readers a report of a typical case of the disease in 
question. 

From the fact that I have seen three cases of the 
disease in a country practice of eleven years, and have 



Our Clinical Society. 291 

conversed with a number of physicians who have been in 
practice two or three times as long, and who say they 
never saw a case of the disease, I am led to believe that 
perhaps many cases of the disease are overlooked and 
unrecognized, and as it was only in consequence of the 
impression made on my mind by reading an article on the 
subject in question in the American Journal of Medical 
Sciences of April, 1875, written by Dr. Philip A. Wilhite, of 
South Carolina, that 1 was enabled to stumble on to the 
true diagnosis of the case hereinafter reported; and 
also led to adopt the treatment that proved successful. I 
trust this clumsy report may lead some to a further 
investigation of a subject of which there is yet probably 
much to learn. 

On September 13, 1875, was called, about daylight, 
three miles in the country to see the infant son of CI. S., 
then three weeks of age. I found the child very much 
emaciated and in a very restless, irritable condition, unable 
to sleep and found that for several days past it had slept 
but little, and that for at least twelve hours past it had 
been able to suck but very little. The abdomen seemed 
tender and tympanitic, and there were frequent discharges 
of a greenish, griping character; also an irritable hacking 
cough. Every few minutes the child would utter a 
peculiar, unnatural cry, and the expression of the counte- 
nance and features appeared to denote great pain. At the 
same time there would be a tonic spasm of the voluntary 
muscles of the body lasting for a few seconds. Several 
attempts were made while I was there to have the child 
nurse, but when the nipple was placed in its mouth it 
would instantly cry out and close its mouth firmly on it, 
followed by a general tonic spasm. 

These paroxysms, I noticed, would be induced by a 
noise, a touch or a gust of air touching the body. I did 
not recognize the trouble for 1 supposed the nervous 
disorder was probably due to trouble in the bowels, and 
left an opiate and carminative mixture to be given at 
frequent intervals until it should produce a decided effect. 
Seven hours after 1 left, the father came to my office and 



292 The Peoria Medical Monthly. 

said the child had been getting worse ever since I was 
there: that it had not slept a minute; could not nurse at 
all. and. as he expressed it, "appeared to be in spasms all 
the time." He thought it could certainly live but a little 
while, but if I thought an3^thing could be done lor it, 1 
should go out and see it. About this time a recollection of 
Dr. Wilhite's article, before referred to, flashed on my 
mind and I began to realize that I had on hand a case of 
the disease in question, "tetanus nascentium." Having on 
inquiry ascertained that the mother held the child with its 
occiput resting on her arm most of the time, even letting it 
lie on her arm at night, I told him to hasten home and 
have the child laid on its side on a pillow and in fifteen 
minutes change it to the other side and so continue to 
change it until I should see it. In three-quarters of an 
hour after he got home I saw the child; found it sleeping 
soundly and quietly and had the testimony of, at least, half 
a dozen friends present that in less than five minutes after 
it was laid on its side the child ceased all spasmodic move- 
ment and was quietly sleeping. After leaving it sleep thus 
for twenty minutes, when on turning it over it awoke. It 
was given the breast, nursed freely; was laid on the other 
side where it was sleeping quietly still when I arrived. 
My own surprise w^as equalled only by the friends who had 
witnessed the sudden and remarkable change. To assure 
myself and those present of the course of the trouble, I 
found on examination that the occipital bone was de- 
pressed fully the thickness of the bone below the parietais 
at the lambdoidal suture. On applying moderate pressure 
on the occiput with my hand, the child was instantly 
awakened with the same painful cry. followed by the tonic 
spasm as occurred before the chaiige of position. By 
changing position from one side to the other occasionally 
and keeping it off its back, the child fully recovered with- 
out any medication and is alive to-day — a hearty, robust 
boy. 

From my observation of this case i have no doubt 
that inward displacement of the occipital l)one (a physiolo- 
gical condition before birth, but pathological after birth) 



Our Clinical Society. 29B 

was the cause of the tetanus and just as little doubt that 
it would have proved fatal in a few hours if not treated in 
such a manner as to relieve pressure on the medulla and 
its nerves. 

Two other cases of the disease that have come under 
my observation, were not so severe or so fully developed as 
the one described, but enough so to leave no question in 
my mind as to the nature of the trouble. No doubt earlier 
action of the same character, as in the first case, prevented 
the extreme condition occurring, as there was a plain 
depression of the occiput in both of the cases, and each had 
.developed the trouble to the extent of causing difficulty of 
nursing, unnatural wakefulness, great restlessness, while 
each was promptly relieved by changing position from the 
dorsal to tihe lateral decubitus. 

I would, by no means, insist that the cause I have 
given is the only occasion of the disease; but, may it not be 
a more frequent cause than authors would lead us to 
to believe ? 



Art. VI — Triplets, Placenta Previa and Mal-presentation. By Wm. H. 

Veatch, M. D., Carthage, 111. 

I was called to see Mrs. M., August 3, 1884, aged 30 
years, a thin, sharp featured brunette, who presented at 
first sight a worn-out, anxious appearance. She has always 
enjoyed good health with uncommonly steady nerves, 
but whose muscular system is not well developed and but 
little adipose tissue to fill up the intermuscular spaces, 
giving her an uncommonly bony appearance. Has one 
child three years old, which came to full term, and in 
September last had a premature labor at about the sixth 
month of utero gestation, the issue being dead. She 
supposes herself between six and seven months gone now 
in her third pregnancy. She has been in pain almost 
constantly for several days, with extreme tenderness about 
the epigastrium. Is compelled to be propped ap with 
pillows partially on her right side, being unable to either 
sit erect or to remain any length of time in a horizontal 
position. This evening a large quantity of fluid passed 



294 The Peoria Medical Monthly. 

from the womb indicating to her the near approach of 
labor. 

An exploration ot the external abdomen showed it to 
be enormousl}^ distended, even over-lapping the costal 
cartilages, with such pressure against the stomach and 
diaphragm that full inspiration is impossible, and there is 
not room enough in the stomach for sufficient food to 
nourish the bod}^ 

The foetal movements are mostly felt in the region of 
the stomach and against the floating ribs, giving the 
impression that it might be an abdominal foetation. 

Auscultation revealed a foetal heart midway between" 
the umbilicus and the ensiform cartilage, no other foetal 
sounds being elicited. 

Vaginal exploration revealed an undilated t)s, a rigid 
cervix and a distended uterus. 

Diagnosis: Uterine pregnancy in the sixth month of 
gestation with an undue accumulation of amniotic fluid, 
the waste of water being from cysts. Prescribed laxative 
and sedatives. The next day she felt better, having slept 
under the influence of the sedative. 

She progressed fairly until August 10, when the same 
train of symptoms recurred. She is now entirely unable 
to sit or stand up. Another waste of water took place 
to-day with increase of pain. She has been trying to get 
along without the sedatives. She breathes more freely 
since the discharge of water. I prescribe an abdominal 
supporter which cannot be worn on account of the extreme 
pressure against the diaphragm. I order the laxatives and 
sedatives continued. 

August 20, called in haste at 8:30 a. m. I was at her 
bedside in less than twenty minutes from the time she 
determined that true labor was at hand. On entering the 
room 1 was informed that the child was born, but did not 
breath. 1 ordered a bowl of hot water, which was ready 
by the time I had severed the cord, it being pulseless. I 
immersed the child in water at a temperature of 102 
degrees F., and at the same time dashed cold water on 
the face and bio wed forcibly into the mouth. A few 



Our Clinical Society. 295 

repetitions of this process fully established the respiration 
and 1 turned my attention to the mother who is having 
expulsive pains. 

The abdomen has sunken but little from its former 
dimensions. The vagina is completely full of a dense sack 
of water which I rupture with considerable effort, and the 
most wonderful flow of water took place that I have ever 
witnessed. At the next expulsive effort a breach present- 
ing child was born, crying lustily as soon as the head was 
expelled. The expulsive efforts of the mother did not cease 
and as quick as L could dispose of the second child, I 
placed my hand to the vulva, I found the vagina completely 
full of what proved to be the largest placenta 1 ever 
witnessed. Strong efforts continued on the part of the 
woman while I grasped the protruding placenta, rotating 
it in the vagina and making all the tention I thought I was 
warrantable in making, and at the same time grasping the 
fundus in my other hand, I succeeded in drawing the mass 
through the vulva to find another cord attached. 1 ligated 
this third cord with some difficulty, owing to its shortness, 
which only allowed the placenta to pass the external 
genitals. This cord was also pulseless. 

Passing the finger through the os-uteri it came in 
contact with the spinal column of a third child, wdiich lay 
directly across the uterine cavity with the head to the left, 
and the breach to the right of the mother. Realizing the 
situation and the danger to both mother and child, I 
quickly passed my hand into the vagina, with two fingers 
in the uterus I grasped the left inferior extremity, the leg 
being flexed on the thigh and brought it into the vagina, 
leaving the other limb flexed on the body. In this position 
it was soon delivered. The child was dead beyond my 
efforts to resuscitate. The uterus contracted well and 
there was not as much hemorrhage as one might expect, 
which was doubless prevented by the constant firm con- 
traction of the uterus. At 9:30 a. m., I applied a bandage 
to the woman and straightened her up in bed. 

The points of interest in this case are; 



296 The Peoria Medical Monthly. 

1. The over distention of the uterus by the amniotic 
fluid. 

2. The placenta previa in the case of the last child. 

3. The shortness ot the umbilical cord of the third 
child making it exceeding difficult to deliver the placenta. 

4. The mal-preseutation of the third child. 

5. The turning. 

6. The rapidity of the labor, it being only about one 
hour in duration including the turning. 



Art. VII— Inversion of the Uterus During Labor. By Thos. M. McIlvaine. 
M. D., Peoria, Illinois. 

December 29th, 1SS2, I was called to attend Mrs. S. in 
her third confinement. On arriving I found her in the 
second stage of labor, pains strong and frequent, vertex 
presenting, and already in the inferior strait. She had 
been in labor about three hours before sending for me. 
As anticipated the child was born within an hour after my 
arrival, the woman saying it was the easiest delivery she 
had ever had. After severing the child from its mother 
and delivering it to the nurse, I placed my left hand over 
the abdomen and found the uterus well contracted over the 
placenta. In about ten minutes the pain returned and the 
placenta was forced into the vagina, the uterus contracting 
strongly after it. On removing the placenta there was a 
copious discharge of blood, and I felt another body, like a 
placenta, pressing after it, at the same time the uterus, 
which I had continued to feel under my left had, disap- 
peared. A hasty examination of the second body, revealed 
an inverted uterus which was bleeding horribly, and soft 
and flabby. 

Hunching the four fingers of my right hand together I 
made firm and continued pressure in the center of the 
tumor, at tlie same time ordering a drachm dose Squibb's 
ergot. In about two minutes I had the satisfaction of 
feeling the inverted uterus gradually begin to give way 
and in not over five minutes restoration was complete, and 
it could again be felt above the pubes, but still soft and 



Our Clinical Society. 297 

yielding. The hemorrhage continued, and in spite of 
repeated doses of ergot, (two hypodermically) friction over 
the fundus, with afterwards the application of ice, the nec- 
essary contractions did not occur. Becoming alarmed at 
the violence and amount of the hemorrhage, and the sink- 
ing condition of my patient, I sent a messenger for assist- 
ance, and a bottle of iron for intra-uterine use. In the 
meantime I determined to try vinegar within the uterus. 
So calling for the castor bottle, I saturated a cloth and 
carried it on my fingers and carried as far as 1 could into 
the mouth of the uterus. A slight contraction rewarded 
the effort, the first since its restoration, and I again made 
use of the vinegar. The castor bottle was soon exhausted 
and 1 called for the jug, and used it freely. The uterus 
would contract somewhat and the flow lessen, but within 
three to five minutes, I would feel the uterus relax, and 
the flow again begin. Finally I carried the saturated cloth 
into the cavity of the uterus itself and gave it as hard a 
squeeze as I could, then for the flrst time did the uterus 
give a good hearty contraction, and the trouble was over, 
just as my asssistance entered the door. The woman made 
a fine and uninterrupted recovery. 

I have never been able to account for the inversion of 
the uterus in this case. The placenta was normal, no evi- 
dence of any adhesions, and no force was used (or was 
necessary) to expell it. If any one can throw any light 
upon it, I will be many times grateful. 



Art. VIII— Self Castration. A Case. By Marcus Whiting, M. D., Peoria, 111. 

Mr. E. B. M., aged 30, a marble cutter, and fairly 
intelligent, awoke me on the morning of May 4, 1883, at 2 
o'clock, and introduced himself with the following remark: 
"Do not say anything about this, I've cut myself." Im- 
mediately conceiving the difficulty, I jumped into my street 
costume and accompanied him to his room — two blocks 
away. He quickly doffed his pantaloons, which contained 
a good half bushel measure full of old rags, every inch of 
which was saturated with blood, and showed me his 



29S The Peoria Medical Monthly. 

scrotum. Examination showed that he had most effectually 
castrated himself. Though it had been done over two 
hours there was still profuse hemorrhage. As it was quite 
impossible to distinguish the arteries, owing to the muti- 
lated condition of the tissues, as well as the excruciating 
pain produced b}^ the slightest traction on the cord, I pro- 
cured sufficient ice to completely cover the scrotum and 
hypogastric region, and had the satisfaction of seeing the 
hemorrhage cease in comparatively a few minutes. I 
placed him comfortably in bed, and having seated myself 
to await the break of day, he gave me, in substance, the 
following history: Had been for years an exceedingly 
amorous man; had been married eleven years; had a pretty 
and withal an accomplished wife, who at the present time 
was in Iowa. She had absolutely refused to live longer 
with him, and had left the house and was living with 
friends. The reason of this was his passion. He had 
intercourse with her several times during the day, to say 
nothing of the night! She had had eight miscarriages 
which she attributed to his brutishness. She had left him 
on several occasions, in fact, she vibrated between her 
husband's and her mother's house. Their only child, a 
rosy-cheek and apparently healthy girl, was born during 
one of these periods of bitterness, at which particular 
time she spent five months under her mother's roof and 
away from her husband. He thought his mind was 
effected — his nights were spent in horrid dreams and 
frequent emissions, and his days were one longing desire 
to be with some woman. He said he never saw a petticoat 
without lustful desires. This has been the case for years 
and he was rapidly growing worse. Being away from his 
wife he naturally resorted to masturbation. This soon 
became disgusting to even such as he and he resolved to get 
rid of the offending meml)er. He accordingly sharpened 
an ordinary pocket knife to the degree that would 
characterize a razor, and at his usual bed time (10:30 
o'clock p. m.,) after having spent what seemed to be a 
pleasant evening with the folks with whom he boarded, he 
retired to his room and did the deed. Let me interpose, 



Our Clinical Society. 299 

just here, the fact that he had only one testicle. He stated 
he had a severe fall when a lad and the right testicle was 
so bruised and lacerated it had to be extirpated, and 1 had 
no reason to doubt his statement. 

He made an incision about an inch in length along 
the dependent portion of the scrotum and squeezed the 
testicle out. It looked far more formidable than he had 
supposed it would, and he was severely frightened, so much 
so, in fact, that he tried to replace the testicle. That being 
impossible without enlarging the incision, he tied a piece 
of ordinary cotton cord around the arteries, cord and all, 
and amputated just above the testicle. The hemorrhage 
frightened him but the twine could be drawn no snugger 
for even now the pain was well nigh murdering him. He 
tried water to no useful purpose, then he tried pressure 
with his fingers, which proved fairly successful, but his 
fingers finally grew tired and useless, and then the rags 
came into play, and he consoled himself with absorbing 
the blood with them for a short period. Then he betook 
himself to the river, three blocks aw^ay, thinking the cold 
water would be all that was necessary. After spending a 
half hour here, part of which time he was immersed in the 
water, he gave it up as a bad job, and admitted, in his own 
mind, that he had caught a tartar. It was then that he 
made up his mind to consult a surgeon and came to me and 
was treated as above. He was comfortable the remainder 
of the night, and on the following morning he was placed 
under the influence of ether and five small arteries tied, 
the wound cleaned and two sutures partially closed the 
wound in the scrotum. A five per cent, solution of carbolic 
acid was the only dressing for five days. On the fourth day 
the scrotum was slightly discolored; on the fifth day 
markedly so — accompanied with high fever. I did not 
understand this until his wife, who was at his bedside in 
response to a telegram, stated he had gotten up and walked 
out into town on both the fourth and fifth days — had been 
out several hours, and even used his mallet and chisel on 
the latter day. Getting him to bed again I had a poultice 
of charcoal and yeast applied, and gave tincture of iron 



300 The Peoria Medical Monthly. 

iuternall}'. This was the treatment for a week, at the 
h\pse ot which time he was feeling quite well, and every- 
thing looked normal. Resumed carbolic acid and gave 
quinine, iron and stiychnine. He was careful enough to 
remain in bed daring the greater portion of a week longer, 
when he was allowed to be up altogether, and in another 
week was at his old place in the marble works, where he 
stayed until the 3rd of September, when he removed to 
Michigan. He was feeling quite well — unusually so, in 
fact — when he departed. But it would seem from his own, 
as well as his wife's statement, that the castration did not 
have the desired eft'ect. He enjoyed the connubial felicities 
as of 5'ore and was quite brutish. She only lived with him 
two weeks after he was out of bed — then for solace hied to 
parts unknown, since which time I have not heard from 
either of them. 



Art. IX. — The Death Odor. By Joshua Richabdson, M. D., Moravia, Iowa.' 

As a physician's skill is often and truly measured by 
his ability to prognose his cases, and as any means by 
which we may arrive as correct conclusions, are always 
welcomed by the student, I would present the following 
sign of approaching death, which I have never yet seen 
published, and which may prove of interest to many in 
the profession. 

It is this! While in attendance on any subacute or 
chronic case of sickness, if you begin to scent, on entering 
the room, an odor like that from the frying or burning of 
old rancid pork you may very safely conclude that your 
patient will die in a few days at most. 

I have never seen a case recover after that peculiar, 
sourish, rancid, meat-burning odor began to permeate the 
sick room, or bed. Indeed the scent has at times been so 
apparent that I have been impelled to remonstrate against 
the frying of meat near the sick chamber. 

As I have never noticed it in any acute case, have 
based my conclusions as to the cause of this "Death Odor," 
on the following premises: 



Our Clinical Society. 301 

In any acute case of sickness, where death ensues in 
a short time, the atoms which constitute the system, are 
inclined to retain their vitality until the end of life. 
Whereas, m those cases where patient has lingered for a 
considerable time, and especially when he has become 
emaciated, isolated atomic, or molecular death occurs — 
it may be days before final dissolution comes on — that is, 
the weakest and least vitalized elements of the system are, 
one after the other, perishing, and their odors commingled 
with the still living particles, produce their peculiar smell. 



Art. X— Stone in the Bladder and Kidneys. By James M. Armstrong, M. D., 
Colony, Knox County, Mo. 

I have had under my care a case that possesses features 
of interest. Five or six years ago T was called to Mrs. R., 
age about 38, symptoms denoting stone in the bladder, 
which was verified by exploration. 

Assisted by several physicians, we succeeded in ex- 
tracting a large calculus. Her health remained fairly good 
up to this spring, when she again commenced suffering 
severe aching pains in her kidneys accompanied by con- 
siderable general irritation ot the urinary organs and 
ascites, probably resulting therefrom; vainly seeking relief 
by the advice of friends in the use ot certain well known 
patent medicines, much of which had been used before 
medical attendance was sought. A careful examination of 
the bladder revealed no stone, but suspecting one in the 
kidneys, I prescribed Lambert's Lithiated Hydrangea in 
one or two drachms doses four times daily, and before eight 
ounces had been taken, more than twenty small calculi 
were passed, having the appearance of being components 
of one calculus dissolved and disintegrated. So far as the 
IDain in the kidneys was concerned, her relief was imme- 
diate, and the dropsical condition materially improved. 
This relief continues permanent, and indicates the efficacy 
of Lithiated Hydrangea in such extreme cases, as w^ell as 
in all morbid urinary conditions, for it has never yet 
failed in my hands. 



302 The Peoria Medical Monthly. 



' Chicago Medical Society. 

Stated Meeting September 1, 1884. 

There was a very large attendance. 

The following papers were read: 

"Remarks on Aneurisms," with exhibition of a large 
aneurismal sac, by Dr. J. A. Robinson. 

"Recent Treatment of Asiatic Cholera as in vogue of 
late years by European Surgeons in Southern India/' by 
Dr. H. M. Scudder. 

The first paper, by J. A. Robinson, M. D., Throat Phy- 
sician to the Presbyterian Hospital, we herewith publish 
in its entirety, as follows: 

REMARKS ON ANEURISMS. 

In the few remarks I have to make to-night I will not 
refer to the etiology, pathology and diagnosis of aneurisms, 
but only to their treatment. 

The general principles governing the treatment of 
aneurisms, have been to prohibit the patient from taking 
much exercise, to secure as nearly as possible absolute rest, 
and to restrict the diet. When the heart was tumultuous 
cardiac sedatives were exhibited. Such symptoms as 
dyspnoea, pain, etc., have been met with appropriate pallia- 
tives. 

The first attempt at specific treatment for internal 
aneurisms was employed many years since by Albertini and 
Valsalva, and has been known as Valsalva's method. It 
consisted in weakening the patient by repeated blood 
lettings, and by gradually diminishing his meat and drink 
till only half a pound of pudding was taken morning and 
evening, with only a measured quantity of water; so that 
at last the patient was so exhausted he could not lift his 
hand from the bed in which he was ordered to lie from the 
commencement of the treatment. W^hen this stage was 
reached the amount of nutriment was increased until the 
patient's strength was restored. It is needless to say that 
this plan of treatment was with great difficulty carried out, 
and it did not yield the beneficial results which were 
anticipated. In our day it would be regarded as barbarous 
were we to try and enforce it to the extreme to which 
Valsalva reached. A modification of this treatment, con- 



Society Transanctions. 303 

sisting of enforcing absolute rest in bed, and diminishing 
the food and drink, so as to diminish the quantity but not 
the physiological quality of the blood, has benefited a 
number of cases, if not entirely cured them. 

While some physicians have refused to employ the 
depleting treatment, they have resorted to measures fully 
as severe. Dr. Murchison and Mr. Moore, of England, have 
recommended, and in one case tried, the introduction of 
line wire into the aneurismal sac, on the theory that the 
large amount of surface exposed to the circulating fluid 
would produce coagulation of the fibrin e. In the case 
referred to, they introduced twenty-six yards of fine iron 
wire into the aneurismal sac, and it is needless to say, that 
the treatment was unsuccessful, although they contend 
that the result obtained demonstrated the principle was 
sound, and that further experiments were justifiable. 

A much less dangerous and probably more efficient 
mode of treatment is by electrolysis. Pravaz w^as the first 
to use electrolysis for reducing external aneurisms, and 
Cinicelli and others have applied it to internal aneurisms, 
but with very indifferent results. Its employment has 
been extended to thoracic and abdominal aneurisms, but 
in eight cases of thoracic aneurisms, only one was bene- 
fited, the others being unsuccessful. Only one case of 
abdominal aneurisms was cured, and this patient died from 
rupture of tjie sac on account of premature exertion. The 
results obtained from the use of the galvano-puncture have 
not justified us in expecting to hope for much from that 
method. 

Professor Langenbeck has published account of two 
cases which he claimed to cure by hypodermic injections 
of one-half to three grains of Bonjean's watery extract of 
ergot every three days. Balfour says he has tried this 
method frequently, but without any success, although he 
was positive that his ergot was active. 

Pressure as a mode of treatment is wholly inapplicable 
to thoracic aneurisms, amd rarely to abdominal. Dr. 
Murray records a case of abdominal aneurism in which 
pressure on the aorta for five hours, the patient being 
under chloroform, was successful. 

We will now speak of the treatment of internal 
aneurisms by the administration of the iodide of potassium. 
It is conceded by Flint and Bramwell, and insisted on by 
Balfour, that the iodide of potassium is the only drug 
which offers any hope of cure, and that in every case it 
will relieve the distressing symptoms, if it does not effect a 
cure. Balfour says: 



304 The Peoria Medical Monthly. 

'•Qf all the various modes of treating internal aneurism, 
there is not one hitherto mentioned which is not attended 
with considerable risk or danger except Mr. Tufnell's plan 
of perfect rest, while the advantages to be derived from 
some of them are, to saj^ the least, very problematical. 
But the treatment bj" the iodide of potassium, of which I 
shall now speak, is perfectly safe and free from all risk, 
and it is equally certain to afford relief, at least I have not 
yet seen any case where relief was not attained, though 
naturally enough that relief is not always -to be got 
instantaneously, but requires the treatment to be con- 
tinued tor some time. It also relieves the pain and other 
symptoms of aneurism more rapidly and more effectually 
than any other treatment, apart even from the powerful 
agency of the recumbent posture; and for the time it has 
been in use it has given greater and more permanent relief 
to a larger number of cases of aneurism than any other 
mode of treatment whatever. Indeed the relief to the pain 
and other symptoms is so great and so speedily obtained, 
usually from the action of the drug alone, that it is often 
difficult to get the patient to submit to any restrictions. 
Besides it is not always necessary." 

"I, myself, have employed this method of treatment 
during the last eight years in a very considerable number 
of cases, with unvarying success so far as the relief to 
symptoms is concerned, and with such favorable results as 
to retarding the further progress of the case, and even in 
some cases promoting an apparent cure, as certainly to 
stamp this treatment as one of the most efficient hitherto 
propounded for the relief of this intractable complaint; 
while it has certainly the not despicable property of being 
injurious to the patient in any respect." 

Balfour then relates the history of twelve cases treated 
by this method with the following results: the symptoms 
such as pain, dyspnoea, etc., were relieved in every case; 
the physical signs of aneurism were diminished in seven 
ca.ses; pulsation of the tumor ceased in two cases, dimin- 
ished in four, and was not apparent from the commence- 
ment in six. The aneurismal tumor disappeared in three 
cases, and diminished in five; the bruit disappeared in two 
ca.ses and diminished in two cases, but never existed in two 
cases. Five of the patients were so relieved that they 
could work; four were discharged at their own request 
feeling well; one patient absconded and the result of treat- 
ment is not known. Five cases were termed cured, and 
seven were not cured but relieved. 



Society Transactions. 305 

One of the twelve cases referred to was an aneurism of 
the innominate artery, which was cured, and Balfour claims 
to have cured several cases of aneurism of this artery. 

One of the cases discharged at their own request was 
under treatment three different times, being twice at his 
own request, but died suddenly while under the third course 
of treatment. The autopsy revealed an aneurism of the 
aorta which had ruptured into the lower lobe of the right 
lung. 

One of the twelve cases was diagnosed as a weeping 
aneurism, implicating the origin of the left carotid, and 
communicating by a small opening with the left bronchus, 
the patient on admission expectorating arterial blood, but 
this soon ceased and the patient was discharged cured. 

While we do not believe we are justified in being as 
enthusiastic in the praise of the iodide of potassium treat- 
ment as Balfour, we do believe we are justified in relating* 
to you the following case, and give the iodide of potassium 
the credit of prolonging the patient's life and making his 
days comparatively comfortable. 

John H. C, aged 40, a blacksmith, was first seen 
March, 1883. Had had attacks of inflammatory rheuma- 
tism several years ago. In February, 1883, was attacked 
with severe pains in the chest in the prgecordial region and 
treated by his physician for rheumatism for some weeks. 
Dr. J. P. Ross saw him and diagnosed aneurism of the 
aorta. At this time he had a good deal of dyspnoea, some 
hoarseness of the voice, and quite a little difficulty in 
swallowing solid food. When fatigued the pains m his 
chest were excruciating. No tumor was perceptible, 
although there was pulsation in the upper sternal region, 
and dullness upon percussion over the area of pulsation. 

Two months afterward there was a swelling in the 
upper sternal region at the junction of the left first and 
second ribs, about the size of a silver dollar. A very slight 
bruit was heard. The voice was very husky, and the 
difficulty of deglutition had increased until now the patient 
could take no solid food whatever. He had emaciated and 
was losing strength very rapidly. 

He was ordered to lie in bed continuously, and was 
given 15 grains of the iodide of potassum three times daily, 
gradually increasing the dose until signs of iodism appeared. 

It was truly remarkable how soon after this plan of 
treatment was inaugurated the patient expressed himself 
free from pain and the distressing symptoms from which 
he had suffered. He persevered this way until May, when 



306 The Peoria Medical Monthly. 

he said was so well and weary of the bed he would like to sit 
up. Leave was granted. A few weeks after I was surprised 
to see him walk into my office. He complained of nothing, 
but I cautioned him against such rash experiments and 
told him to return home and take better care of himself. 
His condition at this date was as follows: the contiued 
pulsation of the tumor against the chest wall, had produced 
absorption of a large portion of the manubrium and an 
inch of the inner portion of the left tlrst and second ribs. 
Consequently we could feel the pulsation of the tumor 
through the chest wall at a point where onlj^ soft tissues 
intervened. No bruit was discernible. 

On laryngo&copic examination we found completes 
parah^sis of the left vocal cord. His voice was anserinous. 

During all these months he had been taking the iodide 
of potassium without any disturbing effects, until now, 
when he complained of symptoms of iodism. He was 
allowed to discontinue its use. 

From the date of this visit to me he grew rapidly 
worse. He rapidly emaciated, dyspnoea and dysphagia 
increased, and finally he died of asthenia July 19, 1884. 

Autopsij. On opening the thorax a large aneurismal 
tumor was seen behind the sternum, about five inches in 
diameter. Friable adhesions of the sac to the sternum 
were broken up when the sternum was removed. Absorp- 
tion of a large portion of the sternum and the left first and 
second ribs had taken place. Heart and pericardium 
normal Adhesions between the aneurismal sac and the 
left lung. The left lung was pressed upwards and back- 
wards into the left pleural cavity, and collapsed. 

On opening the heart find the aortic valves roughened. 
Extending the incision into the arch of the aorta, find it 
dialated and at the anterior of the arch between the origin 
of the innominate and the left carotid arteries, an opening, 
oval in form, one inch by one and a half, into the sac of 
the aneurism. Through this opening the walls of the 
aorta was continuous forming the v/all of the aneurism. 

The tumor was firm, being composed of coagulated fib- 
rine, was then exhibited by the reader, who replied to numer- 
ous informal quires that were profounded, when Dr. John 
Bartlett, cited briefly the history of a case of general 
chronic_ bronchitis complicated with asthma, occurring in 
a man 70 years of age who was supposed to be suffering 
from consumption for 50 years. Eight years ago when the 
patient came under his care, he ordered him to take 8 
grains of the iodide of potassium three times a day. He 



Society Transactions. 307 

has not omitted a day to take the medicine since, and he 
has steadily improved, his kidneys have performed their 
normal function, his appetite has not been impaired, and 
he has grown fatter and stronger. The case is an illustra- 
tion how long a patient may take iodide of potassium 
continuously without injury to the mucous membrane of 
the stomach, or injury to the kidneys. 

This was followed by Dr. H. M. Scudder, who read an 
interesting paper on ''The Recent Treatment of Asiatic 
Cholera," which epitomized — is — 

First. To relieve the frequently-experienced prodro- 
mic symptoms, by giving ten or fifteen drop doses of spirits 
of camphor in dessert spoonfuUs of hot brandy. 

Second. In the stage of diarrhoea, give chlorodyne 
with spirits of camphor, or plain morphine in alteration 
with an aromatic sulphuric acid mixture. 

Third. In the stage of invasion, apply dry heat and 
mustard plasters, and resort without delay to the adminis- 
tration of morphine combined with chloral by hypodermatic 
injection, and give in addition enemas of acetate of lead. 

Fourth. In the stage of collapse, enforce perfect quiet 
and the horizontal position, anoint the surface and limbs 
with hot oil, also administer perhaps^ atrophine and 
strychnine hypodermatically, and give very small doses of 
alcoholic stimulants by mouth, rectum or hypodermic 
injection. 

Fifth. In the stage of reaction, give mild diuretics, 
and if necessary an emulsion of carbolic acid and bismuth 
sub nitrate, in gum arable water together with bromide of 
potassium for insomnia when required, not forgetting to 
administer well salted hot liquid nourishment in very 
small quantities as soon as the stomach will admit of it, 
also fumigate the premises by sulpuhrous acid gas, or the 
administration internally to the patient of sulphurous acid 
with glycerine in small doses during the first and second 
days of the disease. This paper was generally discussed, 
which we are obliged to omit for w^ant of space. 

LisTON H. Montgomery, M. D., 

Secretary. 



308 The Peoeia Medical Monthly. 



A Text Book of Pathological Anatomy and Pathogenesis. By Ernst Ziegler, 
Professor of Pathological Anatomy in the University of Tuebingen. Trans- 
lated and edited for English students by Donald MacAlister, M. A. M. B., 
etc., etc. Part I, Special Pathological Anatomy, Sections I-VIII. Cloth, 
8 TO-, pp. 365. Wm. Wood & Co., New York, 1884. 

A part of the latest and best work on the subject that 
we know of. Full and complete in every particular with a 
good index. 

A 3Ianual of Diseases of the Throat and Nose, Including the Pharynx, 
Larynx, Trachea. (Esophagns, Nose and Naso-Pharynx. By Morell 
MacKenzie, M. D., Loud. Vol. II, Diseases of the (Esophagus, Nose and 
Naso.Phaiynx. Cloth, pp. 400. Wm. Wood & Co., New York. 

This is a continuation of the work begun in Woods 
Li])rary for ISSO, and needs no endorsement from us, as Dr. 
MacKenzie is recognized throughout the world as one of 
the most accomplished writers on this subject, of the 
present time. It should be in. the library of every general 
practitioner. 

Visions of Fancy. A poetical work by N. M. Baskett, M. D. Cloth, 12 mo., 
pp. 109. Commercial Printing Co., St. Louis, Mo., 1884. 

The Doctor has quite a faculty for rhyme, and puts 
some good ideas and conceits fairly into verse — some of it 
good — some indifferent and some of it very bad. His 
visions of fancy sometimes led him to the heights of 
Olympus and sometimes into a southern barn yard, so that 
there is good reason for unequal merit in the visions. He 
is evidently a man of fine education and should be encour- 
aged to persevere. 

The work is not destined for an extended sale, but to 
those of poetical fancies will prove interesting reading. 

Life and Public Services of Grover Cleveland. By 
Pendleton King. 12 mo., paper, pp. 220. G. P. Putnam's 
Son's, New York. A much more interesting work just now 
would be the private life of the subject of this book. 



I 



Book Notices. 309 

Gun-shot Wounds of the Small Intestines. By Charles 
T. Parkes, M. D., Professor of Anatomy, Rush Medical 
College. Paper, pp. 67. This address has been character- 
ized by high authority as one of the most important contri- 
butions to surgery of the past decade. 

The American Journal of Ophthalmology, edited by 
Adolf Alt, M. D., and published by J. H. Chambers & Co., 
St. Louis, Mo., is rapidly attaining a high place amongst 
the special journals of the day. It is intended for the 
general practitioner as well as the specialist. |2.50 a year. 

Protection and Free Trade to-day, at Home and 
Abroad, in Field and Workshop. By R. P. Porter; 12 mo., 
paper, pp. 48. J. R. Osgood & Co., Boston. 

On the Diagnosis of Tumors of the Anterior Medias- 
tinum. By James C. Wilson, M. D., Lecturer in Jefferson 
Medical College, etc. Paper, 12 pp. 

Medical Education. By Romaine J. Curtis, M. D., 
Joliet, 111. Reprint from St. Louis Medical and Surgical 
Journal. 

The Philosophical Relations of Heat to Disease. By 
R. J. Curtiss, M. D., 11 pp. paper. Reprint from St. Louis 
Medical and Surgical Journal. 

The Care and Feeding of Infants. A handsome little 
pamphlet, containing much valuable information, especially 
concerning Mellin's Food. Copies sent on application to 
the 'publishers, Doliber, Goodale & Co., Boston, Mass. 



A San Francisco crank doctor has made some stir in 
the newspapers by advertising that he was bringing some 
Chinese lepers east, to exhibit and use as an argument 
against Chinese immigration. He was refused permission 
to exhibit his pets in several eastern cities when it was 
discovered that he did not have any lepers with him at all. 
He got plenty of gratuitous advertising, however, and that 
perhaps is what he was after. 



310 The Peoria Medical Monthly. 



CONDUCTED BY DR. 0. B. WILL, PEORIA, ILL. 
Growing: Paius. 

Growing pains are among the minor ailments, which 
althongh discomforting are not usually considered of suffi- 
cient magnitude to warrant therapeutic interference. 
Bouillo, however, in the Gazette des Hopitmix, regards the 
subject as of sufficient importance to warrant him in 
devoting an article to it. He is inclined to classify the 
cause of these pains as a light form of osteo-myelitis, which 
runs its course without suppuration and is most prevalent 
at the time of the most rapid growth. Comparisons may 
also be suggested between it and rickets, being due to the 
faulty circulation of the bones caused by imperfect develop- 
ment. The short and flat bones are seldom affected, the 
long bones being the usual seat of pain, which occur 
chielly near the juxta epiphyseal zone, most frequently 
near the lower epiphysis of the femur. 

In the lighter form the symptoms pass in 36 hours. 
In severe cases there is accompanying fever which may 
last several days and even be attended with some other 
typhoidal symptoms, followed by the sudden fall of the 
fever or recovery. The disease way take a chronic, sub- 
acute form which may last for many months. The 
prognosis is, however, favorable. Quinine and tonics are 
recommended. The disease may appear from the age of 
five years to the twenty-first year, and the symptons may 
be brought on by long walks, strains or fatigue. — Thera- 
peutic Gazette. 



Xervoiis Deraiig-ements of the Heart. 

In the Lancet, June, 1884, p. 1068, Dr. Milner Fothergill 
divides diseases of the heart proper into — 1, valvular; 2, 
muscular; and 3, nervous. It is with the nervous affections 
of the heart that the paper chiefiy deals, and the first of 
these is pure intermittence — a halt in the usual rhythmic 
stroke of the ventricles. It is very commonly met with in 
old or elderly men, and, if associated with organic disease, 
may occasion groundless alarm. It is a mere disturbance 
of rhythm, and, as far as our present knowledge goes, has 
no significance, unless found with other signs of degenera- 



Periscope and Abstract. 311 

tive change; then it has a significance, which, however, is 
borrowed from them, rather than furnished by itself. 
When intermittence is increased by effort, then it is well 
to examine the condition of the circulatory organs. When 
it is found with irregularity ot rhythm, and this becomes 
more pronounced on exertion, the author states that then 
it is nearly certain that there is something more than a 
mere 'neurosal halt.' Another common neurosal disturb- 
ance of the heart is palpitation. Nocturnal palpitation is 
common in women at the menopause, where there is a 
suspicion of gout. In some cases it is brought on by coitus, 
in others it may be relieved by the sexual act. Palpitation 
may be set up by some abnormal condition existing else- 
where. A displaced uterus may be the provoking cause; 
and until the organ is once more in its normal position, 
little relief is obtained from treatment. At p. 1112 he 
describes a form of neurosal derangement of the heart 
which he terms the badly behaved heart. It is mostly met 
with in women; the heart's action is persistently and con- 
tinuously tumultuous, and there is a great deal of actual 
palpitation at times, with intervals when the heart's action 
is quieter, but never calm. The author concludes by draw- 
ing some broad distinctions between organic disease and 
neurosal affection of the heart. Organic change reveals 
itself in two ways: 1st, by signs discoverable upon physi- 
cal examination, and 2d, by physiological indications of the 
effects of effort — as shortness of breath upon exertion, for 
instance. In neurosal affections there are no such evi- 
dences; the heart on examination is found normal except 
there is some perverted action. In the 'irritable' heart, 
however, there is a certain amount of inability to bear any 
strain. The author lays stress on the statement, that a 
neurosal affection of the heart never develops into organic 
disease as a process of development. — London Med. Record. 



Paiuless Escliarotics. 



From the St. Louis Druggist we learn that Esmarch's 
painless caustic powder, for the removal of warts, tumors, 
etc., is composed of: 

B Arsenious acid, part 1, 

Sulphate of morphia, part 1, 

Calomel, parts 8, 

Pulv. gum arable, parts 48. 

This is to be sprinkled on the cuticle daily. The sur- 



312 The Peoria Medical Monthly. 

face should be denuded either with the knife or a blister. 
Cauquoiu's paste, for the same purpose, is made, according 
to M. Charles, by the following formula: 

B Chloride of zinc, fused, parts 10, 
Alcohol, 60 deg., parts 2, 
Wheat flour, parts 15. 

Rub the zinc chloride to a fine powder, add the alcohol, 
rub again and incorporate the flour, strongly pressing 
with the pestle. As soon as the paste is homogenous, 
spread with a roller or bottle into sheets about one-eighth 
of an inch thick, and after a few hours put into a well- 
corked bottle. 

Latour's nitro-chloride of zinc paste, a most excellent 
escharotic, is made by dissolving 50 parts of chloride of 
zinc and 100 parts of nitrate of zinc in 80 parts of water. 
The solution is made by the aid of heat. When it cools, 
add to each 100 parts of the fluid, 75 parts of wheat flour, 
and incorporate as in Canquoin's paste. — Medical and Sur- 
gical Reporter, July 12, 1884. 



Notes of Four Cases of Varicose Veins Treated Avith Hamamelis. 

In April, 1883, I read in the Philadelphia Medical 
Times, No. 402, an article by Dr. J. H. Musser on "The 
Treatment of Varicose Veins with Hamamelis." A few 
days after I read this article, Mrs. W., a married woman, 
age thirty-five, called at my office on account of swelling 
and varicose veins of the left leg considerably swollen, 
with here and there large dark spots, which on pressure 
were quite soft and somewhat tender. These spots were 
as large as eggs, and situated on the inner aspect of the 
calf. The right leg was all right. Mrs. W. was three and 
a half months pregnant with her fourth child. She had 
always experienced trouble with the veins of her left leg 
while pregnant, beginning about the third month of preg- 
nancy and continuing till delivery. In her former preg- 
nancies her leg had been treated by bandaging, which 
afforded some relief, but her distress was so great that at 
times she was compelled to seek relief by lying down. I 
concluded to try the hamamelis, and ordered her to take 
one teaspoon ful extract hamamelis four times a day in a 
wineglassful of water. She began to improve at once, and 
continued to take the drug till delivered. Her leg gave her 
no trouble, the swelling and varicose veins disappearing 



Periscope and Abstract. 3.13 

altogether. Mrs. W. is again pregnant, and the varicose 
veins appeared again at the usual time. She is not taking 
hamamelis with success. 

The second case is a young colored ' man, aged thirty; 
he had varicose veins for two years. He got some relief 
from bandaging, but relief was only temporary. Last 
November he came to my office with a ruptured vein, con- 
siderable oozing of blood. Put on a compress and ordered 
hamamelis, teaspoonful every three hours. Saw him next 
day, took off compress, no bleeding. Continued hamamelis. 
Did not see him again for two months, when he reported at 
my office well. Have seen him several times since, and he 
has had no return of varicose veins. 

The third case was a woman, aged fifty years; was a 
washerwoman; had had varicose veins for a long time; did 
not remember when they first came; was treated by 
adhesive strips and bandage, but always returned after the 
bandages were left off for a short time. I gave her 
hamamelis, two teaspoonfuls three times a day in water. 
She got entirely well in two months, and has remained so 
ever since. 

The fourth case, a woman, aged forty-seven, sent for 
me May 10, 1883. I found her sitting in a chair, bent 
forward till her face was between her knees, her hands 
clasped firmly together, her legs stuck out in front, covered 
with wet cloths. I do not think I ever saw in my life such 
a picture of utter hopelessness as this patient. When I 
approached her she looked up, and in the most piteous 
voice exclaimed, "For God's sake, can you do anything for 
me?" On examining her legs I found the cause of all her 
trouble; both legs were a mass of ulcers from the knees to 
the ankles. From the ulcers was issuing a clear fluid, 
which soon turned the cloths black. Situated a little 
behind the knee were several bunches of varicose veins. 

I thought I had found the original trouble. On 
inquiry, she said at first, some five years ago lier leg was 
full of large veins and considerably swollen, and the ulcers 
came afterward. I put her on extract of hamamelis, a tea- 
spoonful every three hours, and told her to keep cloths wet 
with hamamelis applied to the leg. She recovered in two 
months, and all she has left to remind her of her former 
trouble is considerable discoloration on the anterior aspect 
of her legs. She walks all about the city, experiencing no 
trouble whatever. 

In conclusion, I would say that I consider hamamelis 
almost a specific in varicose veins from almost any cause. 



314 The Peoria Medical Monthly. 

I did not find it disagree in any way with my patients. It 
is not at all unpleasant to the taste. — B. F. NichoUs, M. D. 
—Mcdirul Times. 



Cliolorate of Potash a Specific in Tiiica Tarsi and Porrigo Favosa. 

Dr. C. C. P. Clark once had a case of tinea tarsi in a 
little girl. In spite of all the treatment reccomended in 
the books, the morbid condition of the meibomian glands 
persisted in pouring out their sticky exudation. Consider- 
ing its efficacy when internally exhibited as an alterative 
in certain affections of the mucous membranes, particu- 
larlj^ of the mouth and throat, the patient was given full 
doses of this medicine — about a dram per diem. It worked 
like a charm. Repeatedly the disease returned, as is its 
wont, and w^as as often and as readily subdued. He has 
since constantly used this medicine in that complaint, and 
has never been dis appointed. 

Not long after a lad was brought to the doctor whose 
scalp was thickly bossed with huge, stinking, porriginous 
scabs. Iveasoning from what was seen in the last-men- 
tioned case, the same remedy was used to stay the morbid 
secretion in this, and with like good effect. The crusty 
hummocks disappeared, as a syphilitic node sometimes 
will under the use of the iodide of potash, only far more 
rapidily. He who tries this remedy in this disease, in full 
doses, will not turn again to the scalp-shaving, poulticing, 
etc., which is the customary practice. — -N. Y. Medical 
Journal. 



Treatment of Lioconiotor Ataxia. 

Dr. Muller claims to have had a measure of success in 
his treatment of this affection. The diet, he says, should 
be strengthening. Coffee, strong tea, and undiluted 
alcoholic beverages are forbidden. In the medicinal treat- 
ment a pill is used composed of 15-100 grain of nitrate of 
silver and 1-| grain of extract of ergot. The dose .is one 
pill three times a day, and is gradually increased to there 
pills three times a day. After about twenty grains of 
nitrate of silver have been taken, the pills are discontinued 
for three weeks, when their administration is then resumed 
in the same way. 'i'he treatment may extend' over five or 
8ix months. The anthor does not believe that the disease 
is often of syphilitic origin, and never uses specific treat- 



Periscope and Abstract. 315 

merit unless he can discover unmistakable evidences of 
syphilis. Electricity is often useful, but galvanization of 
the medulla should be practiced as well as that of the cord. 
Faradization of the skin by means of the brush electrode, 
either alone or combined with galvanization of the nervous 
centres, may also be of advantage. The author condemns 
hot water or vapor baths as being positively injurious. 
Cold baths are also contra-indicated. The proper tempera- 
ture for a bath is 84 to 8(5 degrees, and the patient should 
remain in the water for from "three to five minutes only. 
Massage may prove to be of use, though data on this point 
are wanting. Stretching of the longer nerve-trunks is a 
dangerous and unwarranted procedure. For the pains Dr. 
Miller makes local applications of a liniment consisting of 
veratria, four grains; chloroform, half an ounce; and oil, 
■one ounce. For the gastralgic crises he uses strong faradi- 
zation with a brush over the epigastrium. Ocular paralysis 
is treated by the continued current. For the relief of 
vesical spasm, he gives pills containing one and a half grain 
of the extract of cannabis indica. — La France Medicate, 
July 81, 1884. 



Palatable Prescriptions. 



In the Ctncmnati Lancet and Clinic, May 3, 1884, Dr. 
John L. Davis has an interesting and practical article upon 
this subject, from which we take the following: 

It is with the view of suggesting agreeable and appro- 
priate vehicles for some of the most repulsive drugs, that I 
offer the following prescriptions, to which I ask your atten- 
tion. They are the result of a great many experiments, 
and most of them 1 have used in practice, and can recom- 
mend as the best combinations possible without modifying 
the drug in such a way as to affect its action. I have 
attempted to marshal these unruly drugs under something 
approaching order; though I confess the classification is 
far from being a perfect one. A tew drugs of each class 
will suffice to illustrate how the whole class mey be im- 
proved. 

1. Bitter Drugs. — These comprise a very large class of 
unpalatable medicines, the climax of bitterness being 
reached in the cinchona bark. The best prescription for 
masking the taste of quinine is — 

R. QuinisB sulphatis 30 grains. 

Tinct. aurant. cort. recentis 2 drachms. 

Ext. glycyrrhizse fl 5 drachms. 

Syr. simplicis 1 ounce. 



316 The Peoria Medical Monthly. 

Or it may be given with the aromatic syrup of licorice. 
Simply chewing a piece of licorice root before and after 
taking the quinine will very effectually hide its bitter taste. 
The same methods for administration apply equally well ta 
most other bitter medicines. In the American Journal of 
Medical Science (1S7S) Dr. Samuel Ashhurst, of Philadelphia^ 
describes an agreeable method for the exhibition of cin- 
chonia. He uses the alkoloid rather than the more usual 
sulphate; for while being equally soluble in the stomach it 
is less so in the saliva, and consequently its bitterness is 
less marked than that of the sulphate. His prescription is: 

R. Cincbonise 1 grain. 

Sac. lactis 4 grains. 

Natr. bicarbonatis 1-10 grain. 

The soda renders the alkaloid less soluble in the mouth,, 
while the sugar of milk gives it an agreeable, sweet taste. 
Children take this powder without the least aversion. 

The thick, viscid elixir of taraxacum is also a valuable 
vehicle for the administration of medicines. And finally it 
may be said of these as of all medicines that if taken very 
cold, or if a piece of ice is taken into the mouth imme- 
diately before the medicine the objectionable taste will be 
less marked. 

2. Salfij and Metallic Drugs. — A large class of unpalata- 
ble drugs is included under this head. The best prescrip- 
tion containing iodide of potassium is the following: 

K. Potassii iodide 2 drachms. 

Tinct. aurant. cort. recentis 2 drachms. 

Ext. glycj'rrhiz. rad. ti 1 ounce. 

Syr. simplicis y s. ad. 3 ounces. 

Of this each teaspoonful contains five grains, and the 
iodide is so perfectly disguised that persons who have been 
accustomed to its use fail to recognize its presence. For 
this combination I am indebted to Mr. Julius H. Eichberg^ 
the skillful and efficient druggist of the Cincinnati Hospital. 
The vehicle is eligible also for the administration of the 
bromide of potassium. A syrup of coffee is highly recom- 
mended to hide the taste of the iodide — fifteen grains to the 
ounce. The same vehicle can be used for the bromide, 
except in cases where the stimulant effect of coffee is to be 
avoided. 

A simple and somewhat effective way for administering 
the iodide and bromide as well as salicylic acid is in milk — 
ten grains to the ounce. Another mode of giving these 
drugs is to u.se as the vehicle, slightly alkaline, carbonated 
water, either natural or artihcial. This plan was proposed 
by Dr. Leguin (New Remedies, 1883, 195). 



Periscope and Abstract. 317 

The syrup of the iodide of iron is a useful medicine 
which is best given simply with the fluid extract of licorice 
root; this is preferable to the ordinary succus glycyrrhizse. 
A medicine peculiarly disagreeable to many persons from 
its bitter, salty taste is magnesium sulphate. The follow- 
ing prescription offers an elegant means for its administra- 
tion : 

R. Maguesii sulphatis ,...2 draclims. 

Acidi sulpliurici 5 drops. 

Glyceriuse 

AqucB aa. 1 ounce. 

Half of this in a glass of water constitutes an agreeable 
dose of an ordinarily repulsive substance. By the addition 
of a drop or two of mint the mixture becomes not only 
palatable but attractive. 

3. Astringent Drugs. — Tannin is the representative of a 
class of remedies repulsive by reason of an astringent, acrid 
taste. This may be materially improved by the addition of 
sugar of milk and aromatic powder. I have also ordered it 
with powdered licorice, which materially improves the 
taste. Salicylic acid may be given in powder the same 
way. When alcohol is not objectionable the following 
combination will be found useful and agreeable: 

R. Acidi salicylici 8 greins. 

Spir, vini gallici 40 minims. 

Syr. acacise 

Syr. limonis aa. 10 minims. 

Chloral besides having an acrid taste is burning and 
penetrating; and these qualities make it a most difficult 
^substance to disguise. I have seen some alleged palatable 
prescriptions of this drug, in which the only thing disguised 
^nd perfectly hidden was the aromatic vehicle, the taste of 
the chloral being apparently re-enforced and concentrated. 
The best combination containing this drug is a suggestion 
•of Mr. Eichberg. It is this: 

. R. Chloral hydratis 5 grains. 

Glycerinse 1 drachm. 

Or, it may be still farther improved, thus: 

R. Chloral hydratis 30 grains. 

Glycerinse 2 drachms. 

Ext. glycyrrhiz. rad. fl 1 drachm. 

Each drachm of which contains six and two-thirds 
igrains of chloral. These same vehicles may be used in 
giving croton chloral hydrate, a remedy which is remarka- 
bly beneficial in some cases of facial neuralgia. 



318 The Peoria Medical Monthly. 

Another convenient and agreeable vehicle is syrup of 
raspbeny. a drachm of which covers the taste of three or 
four grains of chloral. 

4. EfJierial Drugs. — The syrup of raspberry is also> 
valuable to conceal the disagreeable character of sweet 
spirits of nitre: when taken with this syrup in soda water 
the drug is not tasted. 

Sulphuric ether is best given on a lump of sugar; chloro- 
form has a hot burning taste, which is best modified by B.n 
emulsion; or it may be given with a large quantity ot 
simple elixir. 

5. Odorous Drugs. — A certain class of drugs is disagree- 
able more from odor than from taste, Such are carbolic- 
acid and creosote, very repulsive to some persons. The- 
unpleasant character of the former is fairly hidden hy 
simple elixir, five grains of the acid to the ounce. The best 
way to give creosote is witli simple elixir or syrup and 
madeira wane. 

Iodoform has a very objectionablt; odor, and one- 
method for disguising it is the addition of tannin. The 
compound has a less disagreeable odor than iodoform, but. 
this improvement is made by destroying the iodoform by 
the formation of a different substance. Such prescriptions 
of course are iaiproper. The offensive odor may be removed 
by the addition of various substances, w^ithout affecting in. 
the slightest the physiological action of the drug. The 
best combinations are the following: 

R. lodoformi 1 draohm. 

Nitro benzol 3 drops. 

R. lodoformi , 1 drachm- 

Ol. inyristica> 2 drops. 

R. lodoformi 1 drachm'. 

Eucalyptol 4 drops. 

All of these prescriptions are excellent; the disagree- 
able odor is perfectly removed, while the properties of the 
iodoform remain unaltered. Some samples of these com- 
binations prepared two years ago show as yet no trace of 
the odor of iodoform, though the activity of the drug is 
unimpaired. The odor may also be hidden, though less 
effectually, by oleum myrcia3 (oil of bay) and tonka bean, 
or its active principle, cumerine. 

Nitro-benzol constitutes an agreeable cover for the- 
odor of turpentine. The following is a prescription which. 
I have used: 

R. Ol.lerebinthina^ 10 minims. 

Syr. simp 

MiiciiaKc- acacia; aa 25 minims. 

Nilro-benzol 1 drop. 



Periscope and Abstract. . 319' 

In some cases tiirpentiDO may be best given in pill 
form. And the same may be said of many of the resins and 
gums. 

Assaf(]etida is a substance which the Persians use as a 
condiment, to give their food a pleasant taste. Personally 
1 should prefer to take it in a galatine coated pill, which is 
the least disagreeable method for its administration. 

Given in liquid form, it is an exceedingly repulsive 
drug, whose odor and taste can not be effectually covered. 
By the addition to the tincture of a drop or two of oil of 
orange, and a few drops of aromatic sulphuric acid to the 
dose, its nauseousness becomes slightly less obtrusive. 
This is somewhat preferable — if there can be a choice in. 
repulsive things — to the ordinary emulsions, and mixtures 
containing licorice, tincture of orange, mint, etc. 

Ipecac has a repulsive acrid taste, even as a syrup. If^ 
however, instead of sugar, glycerine is used in making the 
syrupy mixture, the objectionable features are materially 
improved. 

6. Oils. — Such oils as that of copaiba are best given in 
capsule. But some persons are so constituted as to be 
unable to swallow capsules, and for such our only refuge is 
found in emulsions, such as that of bitter almonds flavored 
with an essential oil. 

Castor oil is most easily given with an equal amount of 
glycerine, and a drop of oil of cinnamon to the ounce. The 
oil is not recognizable, and the mixture has only the hot, 
sweet taste of glycerine, agreeably modified by cinnamon. 
This is the best way to give this valuable medicine to 
children. It is also readily taken by children when mixed 
with coarse brown sugar, and having the mass made firm 
by placing it for a few minutes on ice [Bed. Klen. Wochen.). 

A method for its exhibition suggested by Dr. Potain 
{Le Practicien), appears to answer the purpose. A spoonful 
of orange juice is poured into a cup, then the oil is added, 
and finally another spoonful of orange juice. When swal- 
lowed, the presence of the oil is completely unrecognizable. 

By far the simplest and most eligible palatable prescrip- 
tion containing castor oil is that made with the addition of 
glycerine, with or without cinnamon. 

A very nauseating and unpalatable medicine is cod- 
liver oil. Many attempts have been made to cover its 
taste. One of the easiest me'^hods for its administration is 
with the yellow of an egg, a drop or two of an essential oil, 
and half a glass of swetened water; or it may be given 
with glycerine and whisky, or glycerine and compound 



320 The Peoria Medical Monthly. 

spirits of lavender. The oil may be much modified, and, 
to some tastes, improved, by the addition of ten drops of 
the tincture of eucalyptus globulus to the ounce. 

The medicines I have mentioned are those ordinarily 
most difficult to administer. I have spoken of them as we 
have them, without attempting any other improvement 
than can be made by the addition of various substances. 
But in most instances our medicines may be made still 
more agreeable by concentration, and by the use of the 
active principle, as the alkaloids of drugs. 



Tonic Spasm of the Diaphragm. (?) 

We abstract the following from the report of the 
American Neurological Association, as published in the 
last number of the Journal of Nervmis and Mental Disease: 

Dr. A. D. Rockwell, of New York, then read a paper 
entitled, "Tonic Spasm of the Diaphragm (?)" 

The following case was still under observation, and had 
been for a long time. It was unique in character, and, for 
that reason, and because its pathology was so obscure, he 
had been constrained to present it to the Association in the 
hope of exciting an expression of opinion concerning its 
character. 

Mrs. X., thirty-five years of age, the mother of four 
children, began first to suffer from the paroxysms of distress 
about twelve years ago. They had remained substantially 
the same, both in kind and severity, as when they first 
appeared, but their recurrence had been marked by uncer- 
tain and varying intervals. Before January, 1884, they 
seldom occurred more than once a year; sometimes two 
and three years intervened between the attacks. From 
January to April she had two attacks, but for two months 
subsequently the attacks were so frequent that the count 
became lost. For some time they occurred every day, and 
occasionally twice a day, and were fast wearing the patient 
out. Latterly they had occurred between five and seven 
a. m. The patient is awakened from a sound sleep by a 
vague feeling of pressure and distress, which is felt about 
the lower end of the sternum, over the epigastrium, and 
extends to the corresponding point in the back.^ It was 
described as if a crushing weight were being applied, as if 
the front and l)ii,ck were being pulled together. The 
recumbent position during the attack was impossible, and 
the patient leaned forward, moved about, or rested against 



Pfriscope and 'Abstract. 321 

some support, with short gasping inspirations, pallid coun- 
tenance, and with an agonizing expression until the 
paroxysm either subsided or an anaesthetic was adminis- 
tered. The pulse becomes weaker and somewhat less 
frequent, but is not all irregular. 

The attacks last from twenty minutes to three-fourths 
of an hour, and leave the patient much prostrated, from 
which she rallies quickly, however, but a bruised, sore 
feeling remains for man}?^ hours. 

After the attacks became so frequent many efforts 
were made for her relief, with electricity in all its forms, 
together with internal treatment, and all unsuccessfully. 
Dr. Rockwell finally resorted to the actual cautery; no 
attack had occurred for nearly one month, and the general 
health of the patient had improved steadily. 

A difficulty, perhaps, in accepting the diagnosis, tonic 
spasm of the diaphragm, was found in the fact that there 
had never been, even during the severe attacks, any change 
in the contour of the external surface, no drawing in of the 
parts at the parts at the attachments of the diaphragm, nor 
projection of the epigastrium. Any attempt at swallowing, 
also, was always successful. Nevertheless, Dr. Rockwell 
was quite convinced that the symptoms were due to a 
spasmodic contraction of the diaphragm, nothwithstanding 
the absence of certain objective symptoms, such as expan- 
sion and immobility of the lower half of the chest, 
projection of the epigastrium, closure of the oesophagus, 
which he had found emphasized in print and speech. 

REMARKS ON DR. ROCKWELL's PAPER. 

Dr. Wilder asked the reader of the paper if the pain 
described was similar to ordinary cramp in muscles. 

Rr. Rockwell said it was very similar. 

Dr. Dana asked on what grounds angina pectoris was 
excluded. 

Dr. Rockwell replied that the pain seemed to be rather 
low down for angina pectoris, in the epigastrium and 
extending through to the back to a point directly opposite. 
It seemed to him to be so entirely different from angina 
pectoris, of which he had seen a number of cases, that he 
had excluded that affection. 

Dr. Webber asked where the cautery was applied. 

Dr. Rockwell said it was applied all along the spine 
from the nape of the neck to the waist. 

Dr. Birdsall asked Dr. Rockwell if he had satisfied hirn- 
self with regard to the absence of hysteria and hepatic 
calculi. 



322 Th£ Peoria Medical Monthly. . 

Dr. Rockwell said that gall-stones had been excluded, 
that there was no evidence ot hysteria in the case, but that 
the existence of hepatic calculi he had not considered very 
thoroughly. 

Dr. Dana thought it would be physically impossible 
for the diaphragm to be in a state of tonic contraction 
without the abdominal muscles being tense or protruding, 
as this was one of the most noticeable phenomena produced 
in experiment on animals. 

Dr. Rockwell said that that was just the point upon 
which he wished to get some light, and he was desirous to 
know exactly what the condition was. He made the title 
of his communication tonic spasm of the diaphragm, with 
an interrogation point. He was aware that spasm of the 
diaphragm was of veiy infrequent occurrence, yet while 
experimentation showed that there was change in the 
contour of the abdominal muscles when it existed, he was 
not prepared to say that slight spasms occurring in a very 
sensitive person might not take place without producing 
any noticeable change in the condition of tne abdominal 
muscles. 

■ Dr. Spitzka asked Dr. Rockwell if there was any 
change in the action of the rupiratory muscles. 

Dr. Rockwell said that the only thing which he had 
noticed was a slight fluttering^only very slight — at the 
epigastrium. How much it had to do with the action of 
the respiratory muscles he was unable to saj^ The breath- 
ing of the patient was gasping and short, and was per- 
formed largely by the upper portion of the chest, but he 
did not notice any lateral expansion of the walls of the 
chest, 

Dr. Spitzka remarked that the objection urged against 
the existence of tonic contraction of the diaphragm because 
there was no change apparent in the abdominal muscles, 
might 1)0 overcome and explained if there was any change 
in the action of the respiratory muscles, especially if the 
tonic contraction of the diaphragm was onlv slight. 

0. B. W. 



In fill it Digestion. 

The above is the title of a paper l)y Dr. H. R. Bigelow, 
of Washington, D. C, in a recent number of the Archives 
of Pediatrics, in which the author lays great stress upon 
the necessity for nitrogenous food for infants. He says: 
"Tissue growth is a slow process, demanding especial 



Periscope and Abstract. 323 

nourishment, and varied at each advance in age. The 
necessities of the child, both chemical and physiological, 
are not those of the adult, because each is adjusted with 
great exactness to the immediate environment. The excess 
of non-nitrogenous matter, which is an essential to adult 
life, is pernicious to the well-being of the infant." 

"Bidder says that the ptyaline appears only with the 
cutting of the first tooth. Reasoning from analogy,, it is 
not improbable that the pancreatis and intestinal ferments 
are also inoperative until about the eighth month." And 
again: "it (cows milk) maj^ have an acid reaction, or it 
may have come from a cow in heat, or it may be tainted 
with certain vegetable substances obnoxious to the child. 
The natural food of the baby is its mothers milk." 

After alluding to the necessity for intelligent study of 
human milk, and its constituents in their relation to cer- 
tain physiological principles, and the fact that women's 
milk has an alkaline reaction and contains water largely in 
excess, milk-sugar, nitrogenous matter, fat and salines, the 
relative proportions varying with each succeeding month 
according to the exigencies of advancing age, etc. 

Dr. Bigelow continues: Woman's milk contains no 
starch. It may be considered that, in the adult, the 
ptyaline may continue its action in the stomach; that 
particles of unconverted starch may be transformed by the 
pancreatis and intestinal juices. In the infant this rule 
cannot apply. The baby does not secrete ptyaline until 
the sixth or eighth month, neither do the othe?' juices, of pa7i- 
creas and intestine, have aiui transforming power ivhatever 
before that period. It is sheer ignorance to assert that small 
particles ot starch can do no harm since they undergo 
transformation in the intestine, when the truth is that they 
not only act as irritants, but pass out ot the bowels 
unchanged. The attenuant of woman's milk is an import- 
ant factor, of which w^e have little absolute knowledge. It 
is chiefly in consideration of this point, that cow's milk 
cannot ever he safelij substituted for that of the mother. 
Before it can satisfactorily approximate to this great food 
ot nature, it must be radically transformed by some chem- 
ical process, which science has not yet developed. The 
addition of water to cow's milk will reduce the percentage 
of albuminoids into harmonious relationship with human 
milk, but it does not suffice to change the characteristics of 
the clot. To use starch as an attennant is, of course, radi- 
callj'' wrong. 

In view of these facts, it becomes a matter of the 



324 The Peoria Medical Monthly. 

utmost interest to establish some definite principles of 
treatment, in cases where the mother is unable for any 
reason to nourish her child properly and sufficiently. 
There is no known process, chemical or mechanical, by 
which cow's milk alone can subserve this purpose. Up to 
six months of age, at least, the bady needs just those 
equivalents found within the mothers breasts — nothing 
more and nothing less. The compound must be alkaline 
in reaction; it must contain no cane-sugar, because cane- 
sugar must be first converted into grape-sugar before it 
can be assimilated; cane-sugar is frequently subjected to a 
kind of acetus fermentation, producing excess of acids in 
the infant stomach, so that bodily heat will diminish and 
disorders of respiration and circulation will follow), and no 
starch. It must be rich in heat producers, although, as I 
have said before, the amount of albuminoids may vary 
greatly. Position has something to do with digestion. In 
some bad cases it will be found that, if the infant be placed 
in the usual position of a nursing child in its mother's 
arms, that it will assimilate its food when artificially fed, 
much more readily. In the nursing child, a by no means 
inconsiderable amount of heat is derived from the mother's 
body. An artificially fed infant is deprived of this, so that 
there should be some compensatory action in its food. 
There have been many attempts made to overcome this 
difficulty, and our journals have been full of discussions 
upon this matter. It may be said that no artificially pre- 
pared food that does not meet all these requirements will 
be of permanent value in infantile therapeutics. What is 
needed is something rich in carbo-hydrates, with a proper 
admixture of albuminoids, salts and moisture, free from 
starch and sugar, and alkaline in reaction." 

As to the best way of meeting the emergency. Dr. 
Bigeiow appends clinical reports of several cases, one of 
which we reproduce, as follows: 

K. 8., colored, five months old, apparently dying of 
marasmus; vomits frequently; diarrhcea, with inability to 
retain nourishment. Was nursed by mother until two 
months old, then fed by bottle on diluted cow's milk. 
Ordered appropriate remedies, with the formula of infant 
food as advised by Meigs, in very small quantities. On 
second day the child was no better, (ilave small doses of 
brandy, burned with sugar; spice poultices to abdomen. 
Child continues to fail; entire inability to retain nourish- 
ment. At the suggestion of a professional friend, I bought 
a bottle of Mellin's food and subjected it to a very careful 



Periscope and Abstract. 325 

analysis. It seemed to be a close imitation of mother's 
milk— so that I commenced using it at once. The change 
was immediate and permanent, and the patient is now a 
thriving girl of four years. The effort was due to the 
principle in the food which acted upon the curd, and 
albuminoids, and brought the cow's milk into a harmonious 
relationship with human milk. The whole system of the 
child was poisoned by unwholesome food, which it not only 
could not digest, but which was irritating the whole 
.alimentary track. It wanted heat, and it wanted intro- 
gdnous food. I satisfied myself by personal analysis of the 
constituents of the preparation and found that it contained 
the principles which it seemed to me nature demanded, in 
exact combination, and more satisfactorily and more 
cheaply prepared than I could compound upon my own 
prescription. 0. B. W. 



The Diagnosis of Acute Alcoholism. 

Of the numerous cases brought to hospitals for advice 
and treatment there are none, we believe, more difficult to 
decide on than those of persons found insensible in the 
streets. Very frequently there are cases of simple poison- 
ing from excess of alcoholic drinks, especially of an adul- 
terated and deleterious nature, but at times there are cases 
of disease, or are complicated by head injuries, which, if 
not promptly recognized and treated, may ultimately prove 
of a serious nature. We are prompted to refer to the lia- 
bility of errors in diagnosis of such cases, and the necessity 
of great caution in dealing with them Jby the recent occur- 
rence in Glasgow of two cases of this nature, which have 
become public and have excited a good deal of comment in 
the public press. In the first instance, a young man is 
found insensible in the street, is taken by the police to the 
office, and is there seen by the medical officer in charge, 
who gives it as his opinion that the insensibility is due to 
alcohol. In the morning more serious symptoms show them- 
selves, and medical treatment is resorted to, but unfortun- 
ately without avail. A post mortem examination reveals 
that apoplexy was the cause of death. In the other case a 
man is brought by the police to one of the infirmaries, is 
admitted there, and after a few hours is once more sent 
back to the police office as suffering from an excess of alco- 
hol. Soon after his return to the police station it is ob- 
served that his condition is not satifactory; the police sur- 



326 The Peoria Medical Monthly. 

geou is summoued, and he gives it as his opinion that the 
man is suffering from some serious head injury, and sends 
him back to the intirmary from which he had been dismissed 
onl}" a few hours previously. Such incidents as these cause 
a pamful impression on the public mind, and are calculated 
to destroy public contidence in the ability of professional 
men to recognize what is and what is not drunkenness, to 
say nothing of the serious consequences that must accrue 
to a patient suffering from some disease or injury of the 
brain from being thus conveyed through the streets of the 
town at that early period of his illness when prompt medi- 
cal treatment might prove of some avail. We can only 
say that such cases should serve as an instructive lesson to 
all those who are connected with the reception of patients 
at our inhrmaries, and should impress on them the advisa- 
bility of erring on the safe side by not sending away any 
case about which there can be a shadow ot a doubt. — Brit. 
Med. Jour. 



Lyiiiphadeiioina. 



The following case is presented by Dr. Roberts Bartho- 
]ow in a clinical lecture published in the College and 
Clinical Becord for September: 

At first sight this case m.ay not seem of much import- 
ance, but in reality it is of great importance. There is, as 
you see, a bunch of enlarged glands on each side of the 
neck. The auxilliary glands are also enlarged, and I also 
find that the area of splenic dullness is increased. 

That disease characterized by progressive enlargement 
of the lymphatic glands, by splenic changes and profound 
ancEmia, is known as lymphadenoma. Such cases are pro- 
gressive, going from bad to worse, and, ultimately, if not 
properly treated, have but one ending. Is this a case of 
that kind? At this stage it is almost impossible to say. 
It may be enlargement of the glands due to strumous 
disease. I am inclined, for two reasons, to doubt this. In 
the first place, there is no evidence of strumous disease in 
any other part of the body, and, in the next place, there is 
enlargement of the spleen; and the spleen is not only 
enlarged but it is firm. Then the characteristic progressive 
anaemia is not wanting. 

Lymphadenoma is a constitutional disease. The gland 
elements undergo the changes known as hyperplasia and 
and hypertrophy — enlargement of existing elements and 
formation of new elements. 



Periscope and Abstract. • 327 

Various measures have been proposed for the relief of 
this disorder. It has been suggested that the hypertrophy 
of the ghiudular system may be arrested by the extirpation 
of those first affected. It has been found that if the glands 
be removed early, the disease being limited to one group, 
we can prevent its spread beyond the glands first involved, 
shov^ing that there is something generated in the first set 
of glands wdiich undergoes multiplication and which 
gradually affects the glands of the body. 

The*^ treatment must be both systemic and local, the 
latter being the most important. Internally, probably 
more good has been done by phosphorus than by any other 
remedy. It is best given in 1-100 grain doses, dissolved in 
a drachm of cod-liver oil, three times a day. Good effects 
have also followed the use of the syrup of the iodide of iron 
and manganese. These may be given in combination with 
the phosphorus. I have found ergot to do great good in a 
case now in my hands. 

As I have said, the most important part of the treat- 
ment is the local treatment. The best local remedy is 
injection of arsenic into the affected gland. The amount 
of arsenic said to have been used in some cases is almost 
incredible, as much as thirty to sixty drops of Fowler's 
solution having been injected at a time. In practicing the 
injection, ether spray or a piece of lint moistened with 
chloroform, is applied to benumb the skin. The hypo- 
dermic needle is then inserted and a few drops of Fowler's 
solution thrown in. The injection should be practiced on 
alternate days. Various other things have been used 
locally. Injection of iodine has been employed, but it is 
much more painful and less efficacious than arsenic. 

What is to be done for the enlarged spleen? Our 
German colleagues are in the habit of injecting arsenic 
into the spleen. They do this with apparent impunity and 
with great apparent good. I might enumerate many other 
remedies but the most important are phosphorus with cod- 
liver oil and the injection of arsenic. 0. B. W. 



Dr. S. G. Allen, of Vermont, is in jail in Boston charged 
with murder. It is the same old story — finely educated, 
promising, etc., but he would drink too much whisky, and 
in a drunken spree killed a man. 

Menthol headache pencils are having an immense sale. 
The headaches they cure are few and far between. 



THE 

Peoria Medical Monthly. 

THOS. M. MelLVAINE, A. M., M. D., 

Editor and Publisher, 

204 South-JefFerson Street, .... PEORIA. ILL 

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C^tlitailal ieprtm^ttt. 



Important to Every Subscriber. 

Notwithstanding the enlargement of this journal 
necessitating an increase in price, we propose to give all of 
our old subscribers the benefit to be derived therefrom and 
make the following offer to all whose names were on our 
books before May 1, 1884. 

If renew^als are sent at once with whatever is back on 
subscriptions, old subscribers can renew for 1884-5 at the 
old price of $1. To secure this, payment must be made 
now and all dues paid up. This is our mode of thanking 
our subscribers for their help in the past, and of course a 
bid for its continuance, and we hope that it will be 
accepted in the same spirit in which it is made. 



Cottage Hospitals. 

During the past year we have received quite a number ■ 
of letters from physicians asking about the advisability of 
starting hospitals in towns of 5,000 inhabitants or over, and 
the best w^ay to start the work. Perhaps the history of the 
Cottage Hospital of i'eoria, might answer these questions 



Editorial Department. 327 

and show how the work has been done here. When it was 
decided to start another hospital in this city, the most 
feasible plan seemed to be that of a joint stock company^ 
accordingly the first steps were taken under the statutes of 
Illinois, and the canvassing for stock begun. It was not 
thought best to make the capital stock very large, so $2,500 
was decided upon, divided into 100 shares of |25 each. 
Few were asked to take more than one share, the idea 
being to get as many interested as possible. 

No trouble was found in getting the stock subscribed 
and the charter was soon ready. A suitable building in a 
convenient part of the city was leased for five years, at a 
rental of $60 per month. The building was well adapted 
for a hospital, being provided with steam heating, gas, bath 
rooms, etc., etc., and plenty large enough for the accommo- 
dation of twenty beds. The board of directors chosen was 
composed of seven gentlemen, representing various religious 
denominations, and they in turn established a "Ladies 
Advisory Board" of a like number. Before the work was 
fully begun two ladies endowed a free bed, by the annual 
payment of $350, and another lady endowed a second bed 
with the same amount. A third bed was afterwards 
endowed by a former resident of the city, and during the 
first j'^ear the ladies board received subscriptions enough to 
complete the endowment ot a fourth at the same rate, so 
that by the end ot the year we had four beds endowed at 
$350 each, thus giving the hospital an annual income of 
$1,450 independent of other sources of income. The ladies 
board also held two "donation receptions" at the hospital 
which brought in nearly $1,000 in cash and necessary 
articles. 

The medical staff was appointed by the directors to 
serve one year. The directors also appointed an agent 
(without salary) to take the general supervision of the 
hospital, pay bills, etc., etc. A matron was secured at $25 
per month, and the number of nurses are increased as the 
number of patients demand. 

Pay patients are received at from $7 to $12 per week, 
which includes everything excepting medical attendance, 



328 The Peoria Medical Monthly. 

which is the same as in a private house. Patients upon 
endowed beds, and poor patients are attended by the staff, 
without pay. 

Any reputable physician of the city is allowed to send 
patients to the hospital for board and nursing, he attending 
them and collecting his regular fees. During our first year 
sixty-five patients were admitted and cared for, and our 
income from endowments, pay patients and donations, was 
sufficient to equip the hospital and pay all running expenses 
without drawing upon our capital stock. 

The county sends us some patients and pays for them 
at the rate of |7 per week. Several railroads have made 
similar arrangements and more are expected to provide for 
their injured in this way. 

Our experiment has been eminently successful in every 
respect and there is no reason why any town of over 5,000 
inhabitants should not have a good small hospital in 
successful operation. Many physicians prefer to send their 
private patients to our hospital tor operations, and the 
good results justify their so doing. To a small "cottage 
hospital" there is not the same opposition and repugnance 
expressed by patients to going to a large hospital. Make 
your hospital as home like as possible, get the people to 
inspect it, and some, even with good homes will patronize 
it in sickness or for operations for the benefit of the nursing 
and care they will receive. 



!Notes and Coniiuents. 

The next International Medical Congress will meet at 
Washington D. C, in 18S7. 

A dentist's shop is always a pain' institution, and it 
keeps groan' all the time. 

Dr. W. A. Hammond advises all ladies who wish to be 
beautiful to eat plenty of mutton. 

The druggists of Philadelphia refuse to put a poison 
label on a prescription from a physician unless ordered to 
do so by the physician. 



Editorial Department. 329 

"All paths lead to the grave," wrote the poet. A 
wicked eclectic says that the remark is undoubtedly true, 
but particularly so of the allopaths. 

The University of Heidelberg has been offered the sum 
of 100,000 marks, on condition that it would admit women 
to its courses. The offer was refused. 

The true use of a porous plaster, according to a Mil- 
waukee druggist, is "to retain the back in its proper place 
and let the pain crawl out through the holes." 

Cooler weather is at hand and more pleasant times for 
writing, so we hope our winter's Clinical Society Depart- 
ment will be kept full to overflowing. 

A Louisville firm has made a watch for an "Indian 
Doctor" to cost $2,000. He is the same one who was run 
out of several places in this State by the Board of Health. 

The cholera has attacked Naples with an awful 
virulence. The new cases each day number from 700 to 
900, and the deaths from 200 to 400. It is spreading slowly 
in Spain, but is decreasing in France. 

Dr. E. W, Gregory, President of the Missouri State 
Board of Health, has handed in his resignation to take 
•effect January 1, 1885. The next regular meeting of the 
board will be held in St. Louis, October 15. 

Bellevue Hospital must be in a bad sanitary condition. 
Last June, Dr. Williams, one of the resident staff, died from 
typhoid fever, and since then one of the nurses and an 
orderly have died from the same cause. 

The young man who sat upon a piece of iron in a 
blacksmith's shop, and uncermoniously sprang seven feet 
in the air, with a wild shriek of despair, now declares that 
he does not think much of the hot springs as a health 
resort. 

The children of Indianapolis who were given twenty- 
five dollars' worth of pills stolen from a drug store, and ate 
them in mistake for candy, were lucky in one respect. 
The pills were of the homoeopathic variety, and did no 
harm. 



330 The Peoria Medical Monthly. 

Prof. J. Cohnheim, the eminent German physiologist 
and pathologist, died at Leipzig, August 14. He was one of 
the most renowned of Virchow's pupils and followers. He 
died at the early age of 45 years. 

The coming meeting of the Mississippi Valley Medical 
Society at Springfield, September 23-26, promises to be one 
of the largest and most interesting ever held by this society. 
We advise every one who can to attend. Reduced rates on 
railroads. 

We congratulate our readers and ourselves on the 
large amount of original matter in this number, and 
promise that no pains will be spared to keep up the stand- 
ard we have before us — to make this the leading practi- 
tioners journal of the country. 

Cards before us announce the marriage of Dr. F. Cady 
Vandervort, (Rush '81) to Miss Hattie E. Morehouse, on 
Sept. 3d, at Bloomington, 111. The congratulations and 
best wishes of the Monthly will follow the happy couple 
the rest of their lives. 

A medical student gave the following translation of 
the very correct Latin adage: "De mortuis nil nisi bonum":. 
'Trom the dead nothing but bones." He was, probably, 
cousin-German to the young man who, in answer to a 
questain, declared Vir-chow to be the discoverer of vaccin- 
ation. — Medical Age. 

On last Thursday we were present at the removal of 
an ovarian cyst by Dr. R. W. Crothers, of Delavan, 111. 
The cyst weighed 25 pounds and was multilocular in type. 
A note from the doctor six days after the operation says 
patient is making a rapid recovery. 

We begin with this number a second series of articles 
on Electro-Therapeutics, by Dr. Romaine J. Curtiss, of 
Joliet. The former series by Dr. Curtiss were received 
with great interest by our readers, and we can safely say 
that the present series will be as good as the first. They 
will probably run through six to eight numbers of the 
Monthly. 



Editorial Department. 331 

Our friend, Dr. Joshua Richardson, of Moravia, Iowa, 
has devised a very handy instrument that can be used in 
many ways. It is a cap slipping over the end of the index 
linger to which may be attached various instruments, as 
a lance, curette, hook for bringing away the placenta, etc., 
etc. As soon as perfected we will give the name of the 
maker or where it can be procured. 

Some Eastern Doctors, notably one from Philadelphia, 
are getting plenty of free advertising from their visit to 
the International Congress, and the British Medical 
Association. He especially, makes a speech every chance 
he gets, and the journals are sure to get a full synopsis of 
it, prepared probably before he left home. The ordinary 
practitioner is disgusted by such foolishness. 

Among the best, recent devices to aid the physician, 
are the urinary test papers, proposed by Dr. G. Oliver, for the 
clinical examination of urine at the bedside. Parke, Davis 
& Co., have made a neat case containing all necessary test 
papers, graduated pipette, two test tubes, a set of specific 
gravity beads, and a book of instructions for their use. It 
is small enough for the pocket or the buggy case, and 
should find a wide sale. We believe the price in leather 
case is only $1.50, paper $1.00. 

"In a park at night. She: How horrid the mos- 
quitos are. He: Yes, they are fearful. She: Don't you 
know of any remedy, Harry, that will keep the insects off? 
He: Oh, yes, there are — She: 1 hear oil of tansy is good 
to keep them off. He remained profoundly silent for the 
next quarter of an hour." Those New York girls are evi- 
dently well up in materia medica, but wh}'' did Harry 
preserve that long silence? It was ominous, to say the 
least. — Medical Age. 

"Gentlemen," said the professor to his medical students 
assembled in clinic, "I have often pointed out to you the 
remarkable tendencj'' to consumption of those who play 
upon wind instruments. In this case now before us we 
have a w^ell-marked development of lung disease, and I was 



332 The Peoria Medical Monthly. 

not surprised to find, on questioning the patient, that he is 
a member of a brass band. Now, sir," continued the pro- 
lessor, addressing the consumptive, "will you please tell 
the gentlemen what instrument you play on?" "I blays der 
drum," said the sick man. 

A laryngological association, my dear, is we take it, an 
association of larynxes. And a larynx is — well, it is the 
active principle of your "Adam's apple;" the larynx lives 
in your neck, third floor front, between the tongue and the 
trachea; it has nine cartilages, and looks like an old garden 
hose gone to seed. And its uses are — well, you know when 
a little mouse runs across the floor! Well, your larynx is 
what you use then. "Climb on the table with it?" Great 
Scotland, no! Who ever heard of climbing up on a table 
with your larynx? No, girl, you "holler with it." — Bur- 
dette. 

Elizabeth, Queen of Roumania, was the authoress of a 
number of epigrams, some of which are quoted by the 
Century. Among them is the following: "A physician is 
a much more profitable father-confessor than a priest. 
One says to a priest, '1 hate mankind,' and he responds 
* You are no longer a Christian!' The physician replies by 
giving one a does of rhubarb, and in a day or two one loves 
one's fellow creatures as well as ever. One says to a priest 
^I am weary of life!' and he points out the criminality of 
suicide. The physician prescribes a tonic, and one finds 
life amusing again intwenty-four hours." 

Since 1828 cholera has attacked four millions of Rus- 
sians, and killed one million, six hundred thousand. 

Dr. Waugh (Med. and Surg. Reporter), reports the case 
of a woman wdio bore seven living children within thirty- 
two months. 

Sixty-three thousand dollars have been fraudulently 
extracted from the Medical Bureau of the Navy Depart- 
ment, at Washington. 

Dr. W. A. Hammond says he has four novels written, 
and will hereafter publish two a year. He says he would 
rather ])e a novelist than a doctor. 



Editoeial Department. 333 

Dr. Patterson, (Glasgow Med. Jour.), reports the removal 
from the blacder of a man, of a stone of enormous size. 
The weight of the stone was fifteen ounces, its long cir- 
cumference ten and five-eighth inches, and its short diam- 
eter eight and one-eight inches. 

A Dr. Patton, in the Southern Clinic, defines homoeo- 
pathy thus: "Similia similibus curantur; the minimum 
dose; the single remedy; proving the action of drugs upon 
healthy subject." As he says his definition' is made for Dr. 
Palmer's benefit, we trust that he may be understood. 

Dr. Jas. G. Kiernan has been elected Medical Superin- 
tendent of the Cook County Hospital for the Insane, at 
Chicago. No doubt we shall hear of his scientific work 
therein. It is to be hoped that the conditions under which 
he will labor may be such as to admit of his doing such 
work as he desires. 

The Cincinnati Lancet gives the record of the new 
member of the Board of Health of Cincinnati. It quotes 
verbatim from the police court docket. Since 1S7S he has 
been before the court six times, three times for assault and 
battery, and three times for disorderly conduct. Twice he 
was convicted and four times discharged. Is such the 
training required for a reputable efficient member of Cin- 
cinnati's health board? 

A writer in the Medical Index quotes a remark of a 
doctor in speaking of a woman who, while claiming to be 
a Christian, had performed many abortions upon herself. 
"What will this woman do when she knocks at the pearly 
gate, and, in reply to the question of the angel guard, 
'Shall she be admitted?' there comes a response from half 
a dozen infant voices of 'No! no! We are afraid of her; 
she murdered us on earth!' " — Detroit Lancet. 

The Weekly Drug News tells the following: "A physi- 
cian called for some bromine at a Hudson River town a 
short time since. The clerk opened a can in which the 
bottle was packed in plaster of Paris. Having made sure 
that he was right by an examination of the label, he 



334 The Peoria Medical Monthly. 

dispensed the required amount of plaster in a paper, which 
was accepted by the doctor as what he had ordered. Some 
time after, the medical man re-appeared, and finding the 
pharmacist in, asked him for some more of the same 
bromine he had obtained there before, as it had worked 
like a charm." Bright pharmacist and brighter doctor. 

The medical appointments to the Cook County Hospital 
are said, by a Medical Times correspondent, to take place 
thus: "Commissioner Hans Olson nominates his friend 
Hans Jenson, M. D.; Commissioner Patrick Murphy nomi- 
nates M. O'Flannigan, M. D.; Commissioner Bingerheimer 
nominates Dr. Ernst Sleisenger. They are unanimously 
elected." Thus the interests of a great hospital are handed 
over to mere politicians. — Detroit Lancet. 



Reading- Notices. 



When an infant does not thrive well, the cause is in nearly ever3^case, im- 
proper food. Hon. Ernst G. Timnie, Secretarj' of Slate, Madison, Wisconsin, says : 
'"It gives me great pleasure to say, that having raised two children upon Horllck's 
Food for Infants, I am satisfied that it affoi'ds complete nourishment, promotes 
muscular strength, firmness of flesh, and that it is the very best preparation for 
the nutrition of young children." Book on treatment of children sent free. 
Horick's Food Co., Racine, Wis. 

At the meeting of the National Medical Association, held at Columbusj 
Ohio. Dr. J. E. Borland reported a case of Uterine Hemorrhage of twenty-five 
years' standing, which was successfully treated with S. H. Kennedy's Extract of 
Pinus (.'anadensis. He also spoke very highij^ of this remedy in the treatment 
Leucorrhea. 

Pinus Canadensis is a specific in Gleet. Its action is prompt and 
permanent. 

Teaspoonfal doses three times a day, of Acid Mann- ate will keep the 
bowels in a solul)[c condition, favor the secretion of bile and gradually lemove 
the congested and torpid condition of the liver, 

Dr. J, A. Larabeee, Prof. Diseases of Children and Mat. Med. and 
Therapeutics, Hosp. College of Medicine. Louisville, Ky., says: "I have made 
quite e.\t*'nsive use of that valuable prejiaration. viz. : Iodia, during the past 
year, and have found its therapeutical value to be fully e(|ual to the elegance of 
the pre|)aratioH. In fact, iodia has been almost a stereotype ingredient with me 
in mi.xiures designed to produce an alterative efi'ect. In chronic diseases of the 
liver, tertiary sypiiilis, and rlieumatism, it has given good results." 



It Gives Satis^f action. 

D. B. BrNN, M. D. Randall, Arkansas. 

Dear Dr.: — We I'ecelved your supporter a few weeks ago. Will say we 
are rnucli jdeaseil wiih it. It was used in a very olt.stinate case of retrovertsion 
whicli wiis not benefited l»y any other ■sui)porter tJiat we used. The patient is 
well plen.sed willi it and said: (Dh ! I am so glad you Ihonght of that kind of a 
supporter." I eiiclo'<fd find five dollars for which send us three of Bnnn's 
uterine supporters. Resiiectfully, Drs. Craig «.*o Donnelly. 
Mancliester, Iowa, Augu.st 0th, 18^4. 



The Peoria 
MEDICAL MONTHLY. 



Vol, V. NOVEMBER, 1884. No. 7. 



#t:i0tttal OHomtttuniatiottsi. 



Abt. I. — Electro Therapeutics. By Romaine J. Cubtiss, M. D., Joliet, Illi- 
nois, Professor of Hygiene and Slate Medicine in the College of Physi- 
cians and Surgeons, Chicago, 111. 

Case 3. Mr. D., is about 30 years old and a bachelor. 
Like many more prominent men in politics, letters and re- 
ligion, he sometimes sows a little " wild oats." Two or three 
months ago he spent about six weeks in an active cam- 
paign, not according to the gospel of either the ancient or 
modern St. John, and was considerably prostrated by the 
effort. The trouble terminated in the recurrence of a 
hernia on the left side, and an inflammation of the inguinal 
glands. The gentleman came to see me with the rupture 
down, and I replaced it by taxis very readily, and then 
endeavored for a time to do the same thing with the glands, 
but had to surrender. After this the gland continued to 
come down for some days. He couldn't wear a truss. In 
a few days glandular enlargement was the size of his fist, 
the skin somewhat reddened, and the enlargement ap- 
peared to prevent further trouble with the hernia. I was 
careful to keep patient in bed, and to keep the hernia up, 
so as to prevent " irreducible " complications. There was 
no history of chancre ; poultices were applied to the gland, 
or over it, as I supposed the gland would suppurate, but it 
continued about the same week after week. I have hereto- 
fore used galvanism to such glands with the effect of aiding 



402 The Peoria Medical Monthly. 

suppuration, but I tried the static machine in this case.. 
The static current was used by placing the feet on a metal 
plate, and applying the other pole next the skin all over 
the swelling. The treatment was used every day — about 
20 minutes each time. I was expecting every day to see 
softening and suppuration, but in a few days the size began 
to be less, the tenderness left, and after ten days treatment 
the enlargement disappeared. The hernia has not re- 
turned. 

Case 4. C. is a physician and surgeon, I judge about 
36 years old, robust and healthy, and a good liver. After 
exposure te cold, wet and fatigue he was called to attend 
a severe case of sciatica in his left sciatic nerve. He took 
" everything " for this trouble and applied the remainder 
over the affected nerve in the shape of liniments. He 
endured the pain which was excessive for nearly a month, 
attending to patients as he could, and going about on 
crutches. The doctor is a reading man, and seeing reports 
of cure of cases of sciatica published in the Peoria Medical. 
Monthly he reported to me for treatment by static electricity. 
He appeared with two crutches and walked with excessive 
pain, I advised him to use *a hypodermic dose of morphia, 
and atropia, which he did'nt do, and the next morning 
after he reported, I began the treatment by the use of 
Static electricity, placing his foot on the plate and applying 
the other pole over the affected nerve, and especially high 
up the spine, so as to enclose the cord and origin of the 
nerve in the ciicuit. The applications weji'e made twice a 
day for seven days, when the patient called himself cured. 
The improvement after each treatment was very marked. 
I believe the-doctor has remained well ever since. 

Case 5. Mr. , is over sixty years old, and a poor 

laboring man, the kind of man who divides the heart of 
the ambitious politician with presidential ambition. This 
laboring man had a "lame back" — 1 suppose it was lum- 
bago, and I suppose lumbago is muscular rheumatism. 
The man could'nt labor ; he could get up with great diffi- 
culty, and after ho was up, could walk about but with 
considerable pain. He applied to physicians who prescribed 



Original Communications. 403 

liniments and medicines, and he had a plaster on his back 
full of holes, but the pain would'nt run out of the holes 
(see the ad. of the Oshkosh Druggist.) The patient came 
to my office eight times, and I applied the static current in 
the usual manner. He came twice a day and was cured in 
four days. No medicine. 

Case 6. Mrs. , aged 70 years, for the last year 

has been troubled with sleeplessness. The disease is not 
insomnia per se, but after a nap of an hour she would be 
wakened by a twitching of the muscles of the lower limbs, 
which would persist for several hours, and keep her awake. 
She was quite feeble, and has valvular disease of heart, but 
no dyspnoea or dropsy. I could not find a source of irrita- 
tion which might cause the twitching of muscles by reflex 
action, but found that the spine was tender at some points, 
and as the patient had been under treatment and taken 
chloral hydrate, opium and bromides, I prescribed no 
medicine, but determined to try the static current. The 
patient did'nt want medicine. I thought that owing to 
vaso-motor pathology the motor tract had a centric irrita- 
tion which kept up the muscular twitchings, and that the 
case might be changed by electricity. The patient came 
every other day for perhaps three weeks. There was no 
immediate improvement, but after about ten treatments, 
she would sleep two or three nights and then have 
trouble the next night. She continued to improve, and 
the last time she came to my office for treatment, she was 
much improved, and said the muscular trouble seldom 
came, and when it did, it would soon pass away, and she 
could sleep. She thought her troubles about over, but 
unfortunately, about this time she fell and fractured her 
arm, and I have not seen her since. 

Case 7. Miss Z., is an elocutionist, about 20 years old, 
and while practicing a loud piece for declamation on the 
fourth of July, which should fire the patriotic heart, she 
became very hoarse, and the next day lost her voice. She 
could speak but above a whisper and was very hoarse. I 
examined the vocal cords and could find no inflammation 
except the usual chronic naso-pharyngeal catarrh which 



404 The Peoria Medical Monthly. 

everybody has more or less. The vocal chords were evi- 
dent partially paraUzed by over work. 

I prescribed rest for two days and treatment of the 
vocal chords, or larynx twice a day with the static current. 
" The Fourth " was only four days ahead when the treat- 
ment began, but the cure was complete on the appointed 
day, and the young lady delivered her speech with credit. 
I used the electricit}^ by placing the feet on the plate and 
applying the other pole over the larynx. 

Case 8. Mrs. , age 30, a widow with two children, 

music teacher, was tormented with occipital neuralgia. 
She said that the pain had troubled her for two years or 
more. The vertebra prominem was tender, and the pain 
seemed to start from there and extend up the neck and 
back of the head. There was no definite rhythm about the 
pain, but it began with least fatigue and lasted until she 
slept. I prescribed Fellows' hypophosphites and used the 
static current in the usual manner,one pole to the affected 
part — the treatments were applied every other day for six 
weeks. At the end of this, patient had gained fifteen 
pounds, the pain was gone, and the patient said she was 
well, and if she did'nt " stop doctoring she would be as fat 
as her mother," which was'nt to be thought of as the 
parent is too Falstafl&an in weight for comfort, and can say 
*' oh, that this too, too solid flesh would melt." 

Case 9. Mr. D., aged about 35, a spirit drinker by 
habit, and leather worker by profession, undoubtedly had 
gout. He suffered an attack in the foot three months be- 
fore I saw him and was sick three weeks, and his prescrip- 
tion which I saw was salicylate of soda and colchicum. 
He was attacked again, aud somebody told him electricity 
might help him. He came to my office twice a day for 
five days beginning his journeys with a buggy and two 
crutches. The relief after each treatment was notable. 
On his last trip he discarded crutches and came on foot. I 
put the foot on the plate and applied the other pole over 
the part of the foot affected. Several months have passed, 
and there is no return of the malady. I gave no medicine 
in this case — the patient declining to take any. He thinks 



Original Communications. 405 

static electricity is a specific for gout, in his case at least, 
and I have marked it down. 

Case 10. Miss -, aged about 30 (I guess,) a teacher, 

worked very hard in school, and continued very hard work 
during vacation, preparing for an examination for promo- 
tion. She broke down and the chief unpleasantness was 
insomnia; she had supra orbital neuralgia, and various 
other pains and aches, and several of the spinal vertebra 
were sensitive to pressure and percussion. She was afraid 
of chloral, but took Fellows' hypophosphites, and I used 
the static current every other day, one pole to feet, and the 
other to hands and spine. She began soon to improve, and 
after continuing the treatment three weeks was quite re- 
stored — eating and sleeping were normal and apparently 
gained flesh and blood. 



Art. II — Vinegar in the Treatment of Bowel Complaints. By Wm. H. Veatch, 
M. D., Carthage, Illinois. 

In the October number of the Monthly, page 393, under 
the head of "A simple remedy in diarrhoea," the author says: 
"My simple remedy for diarrhoea etc., is worth knowing and 
remembering." 

As the experience of the reader is invited, I will say, 
that for twenty-five years 1 have been in the habit of using 
vinegar either alone or in combination with other remedies, 
with satisfactory results in bowel complaints of both child- 
ren and adults; particularly where there is a tendency to 
muco-purulent or muco-sanguinous discharges. In dysen- 
tery I regard it as one of the very best remedies in 
combination with other therapeutic agents. I cannot now 
say w4iere I first got the idea, but it strikes me that I 
either read it in a medical journal or in some domestic work. 
I have a very distinct recollection of a case treated in the 
year 1858 which left its lasting imprint on my mind. 
In the month of August of that year, T was called one 
evening to go twelve miles away, to consult with two other 
physicians in a case of a child who was said to be dying of 
dysentery. On my arrival 1 found that the other physicians 



406 The Peoria Medical Monthly. 

had abandoned the case as hopeless and had gone away. 
The patient, a bright little girl of three summers, was to 
all appearances in a state of collapse. The extremities 
were cold, the mouth and fauces dry, the teeth covered 
with a reddish brown sordes, extreme thirst with apparent- 
ly no choice ot fluids, so it was drink; the discharges from 
the bowels sanguino-purulent, and had been as frequent as 
every thirty minutes, during the latter part of that day; 
no radial pulse, heart's action quite feeble and irregular, 
skin pale and shrunken, in fact all the signs of collapse 
w6re present. I ordered the child placed in blankets, 
dipped in hot water and give the following: 

5 Chlor. Soda 2 drachms. 

Tr Capsici . 2 fluid drachms. 
Vinegar 2 fluid ounces 

Boiling W^aler 3 fluid ounces. M. 

Sig. A teaspoon ful every five minutes as hot as the patient 
could swallow it. 

Before oae half of the mixture was given the child 
began to revive; the extremities became warm, the skin 
became natural in appearance, the sordes was washed from 
the teeth by the vinegar, and she had no more action from 
the bowels for six hours, and then it was of a bilious character 
mixed with the remnant of the offensive sanguino-purulent 
discharge. A few doses of quinine and dovers powder 
was all the medication she required in her after treatment; 
with proper directions as to dietetic rules she made a 
speedy recovery. • 

This was an extreme case and was so impressed upon 
my mind that I ever had the case and its treatment before 
me. 

1 have treated many hundreds of cases of mucous 
diarrhoea and dysentery with vinegar variously combined, 
and am seldom disappointed in its action. 

In low cases of dysenteric diseases I am rather partial 
to the above formula. I have given adults ounce doses 
repeated every few minutes. Fre(|uently there is a thin 
watery stool following the administration of this mixture, 
and when that is the ca^e, I follow it with a full opiate 
which frequently ends the case. 



Our Clinical Society. 407 

I have not had as favorable results in the ordinary 
watery diarrhoea as in the dysenteric tendency of bowel 
complaints, but it usually puts an end to the griping and 
tormina. 

In the dysentery of malarial origin, I have never 
found anything to stop the chilly sensations and the pain- 
ful discharges so nicely as the mixture named above. 

I can say truly "my simple remedy is worth knowing 
and remembering." 



®ur (l^Iinial J^ofUty; 



[For this department we hope to enlist the co-operation of our friends. Short reports of 
interesting cases are especially requested from every one. We ■would like to have twenty or 
more such articles for each number. See editorial in No. 1, Vol. V, May, 1884.1 

Akt. III. — Injury of the Urethra. — Aspiration of the Bladrter — Recovery. 

By A. B. Anderson, M. D., Pawnee City, Neb. 

The following case having some points of interest, I 
send you, for publication. I was called July 29, 1884, to 
see Paul H., a lad of 10 years who had fallen the day pre- 
vious, from a fence, astride the iron spring of a wagon seat. 

Dr. Collins, the family physician was called soon after 
the injury and administered some remedies for his relief. 
But the night passed and the following forenoon, and he 
was yet unable to urinate. At the time of the" injury, on 
being carried into the house, the lad protested that he 
wanted to made water but that it run into his hag. At the 
time I was called he was suffering paroxysmal pains due to 
distention of the bladder. Examination of external parts 
showed extensive bruised condition of right side of scrotum, 
perineum and right groin. A drop of blood was noticed 
within the meatus. A gum catheter was passed down 3 or 
4 inches, and a few drachms of slightly bloody urine flow- 
ed through it. However, all efforts to give entrance to the 
bladder by this route failed. There being no positive evi- 
dence as to where the urine would tend to make an outlet, 
although it was believed to be through the scrotum, it w^as 
not deemed proper to attempt to reach with a bistoury, the 



408 The Peoria Medical Monthly. 

rupture we believed to have occurred. Hence at 11 o'clock 
p. m. of this, the day after the injury, the distention having 
increased to the extent of demanding relief, it was deter- 
mined to use the aspirator. A medium needle was usfed 
and about 24 ounces of normal urine was withdrawn, with 
great relief to the patient. The treatment at this time 
consisted in the use of warm fomentations to inflamed 
parts with belladonna and colchicum internally. 

Patient rested well through the night. Wednesday, 
temperature 100, pulse 120. Parts very much swollen and 
discolored. Continued warm application with cosmoline, 
also internal treatment. At about 8 o'clock p. m. aspirated 
at about 1 inch from former point of penetration and drew 
off 16 ounces of slightly turbid urine. No attempt was 
made during the day to use the catheter. Thursday, no 
movement of the bowels since date of injury. Magnesia, 
castor oil and enemas had been given without effect At 
this time passed soft catheter without stylet about 4 inches, 
when a stream of normal urine began to flow, and contin- 
ued until about two ounces were evacuated, being some- 
what bloody at the last. Failing to reach the bladder with 
the catheter, again used the aspirator, getting about 1 pint 
of rather highly colored urine. Rested well through the 
night, temperature 101^, pulse 120. Friday, called early, 
found the boy asleep, went to the country and returned 
early in the afternoon. Patient again suffering from dis- 
tention, but more from swollen and inflamed condition of 
injured parts. Right thigh oedematous, and evidence of 
urine in the scrotal sac. Passed a bistoury in the right 
scrotal cavity making a free opening. The patient being 
under the influence of ether, the bhidder evacuated itself 
by this channel, giving complete relief to all the symptoms. 
The various seats of inflammation rapidly declined except a 
point in the right illiac region, which proceeded to suppur- 
ation in 3 or 4 days, evacuating upon incision a large quan- 
tity of pus, with an enormous core resembling a partially 
disorganized blood clot. When this point of inflammation 
began to show itself, it was thought possibly to be the re- 
sult of the aspirations. However, later developments 



Our Clinical Society. 409 

showed this was not the cause of this abscess, which was at 
a distance of 4 or 5 inches from any puncture by the needle, 
and doubtless had its origin from the injury received by 
the fall. The treatment was now directed towards recup- 
erating the worsted system, and the patient was put upon 
tonics, milk punch and the best of food. The urine passed 
out through the scrotal fistula for about four weeks when 
it began to close up and it was determined to operate for 
the cure of the fistula and the re-establishment of the orig- 
inal water passage through the urethra. Accordingly on 
the 1st day of September, assisted by Drs. Collins and 
Henry, after numerous attempts and failures to introduce 
a catheter into the bladder, the fistula was open up down 
to the urethra. This was found to be completely severed 
and the upper portion closed by adhesions. An incision 
was made through at this point upon a silver catheter 
introduced and held -firmly by an assistant. With little 
difficulty the upper and lower portions were connected, the 
catheter passed to the bladder and was secured with tapes. 
A rubber tube was attached to the end of the instrument, 
connecting this with a nursing bottle for a urinal, the 
patient turned upon his side, an antiseptic compress ap- 
plied to the incision, in the urethra and the case turned, 
over to dame nature. The fistulous opening closed rapidly 
and at the end of the fifth day, the catheter producing 
some versical irritation was removed. We expected to 
introduce the catheter in a day or so, but it was altogether 
unnecessary as the urine flowed through the natural chan- 
nel and the artificial opening was completely closed. 



Art. IV. — Tonic Spasm of the Diapliragm? By Wm. H. Veatch, M. D. Car- 
thage, 111. 

In the September number of the Monthly is an abstract 
of Doctor A. D. Rockwell's case of so-called " Tonic Spasm 
of the Diaphragm," taken from the Journal of Nervous and 
Mental D leases. 

In perusing the history of this so-called unique case, 
I was forcibly reminded of two cases, which came under 
my observation over twenty-five years ago. 



410 The Peoria Medical Monthly. 

The discussion which followed the report of Dr. Rock- 
well's case, induced me to look up my old case book, that 
I might compare notes, and after doing so, I must say I be- 
lieve Dr. Rockwell's case and mine were affected with the 
same disease, whatever difference there may have been in 
their origin; and at the risk of severe criticism in presenting 
ancient and stale news, I submit the cases for what they 
are worth to your (up to the times) readers. 

Messrs. R. and J. Mc. , natives of the state of 

Kentucky, settled in this state, (111.,) with their families in 
the year 1858. 

Early in the next year I was called to treat a child of 

R. Mc. . While in attendance upon child I observed on 

several occasions that the mother appeared ill. Her ap- 
pearance was that of a person in great physical and mental 
distress. On each occasion she would pass quickly from 
the room, and from another apartment I could hear short, 
spasmodic respirations with a sharp wheezing sound accom- 
panying each inspiration, and a kind of whining groan 
with the expirations. These sounds only lasted a few 
minutes, Avhen they became less audible and finally ceased 
altogether. In a short time she would re-appear, her hands 
pressing upon her sides over the floating ribs. Her 
countenance betokening extreme melancholy, and her 
general attitude showing exhaustion, while deep tremb- 
ling sighs were emited every few respirations. ^ 

On one occasion her sister Mrs. J. Mc. was in 

attendance. I was sitting near the couch of the sick child 

and Mrs. Mc. , No. 2 sat quite near me at the 

cnild's head. A sudden pallor came over her face, and a 
short catch of the breath as if from a sharp pleurisy, at 
the same moment placing her hands on her sides over the 
floating ribs, bent forward and rested her head on the 
pillow, and appeared to be struggling for breath. At length 
a convulsive movement of the shoulders occurred, and then 
a decided backward curvature ot cervical and dorsal regions 
of the spine took place, accompanied by a whistling or 
wheezing inspiration loud enough to be heard in any part 
of the house. After a dozen or more inspirations of this 



Our Clinical Society. 411 

character the severe symptoms began to give way, and in 
a few moments a slight tremor shook the whole frame and 
the paroxysm was at an end. 

For thirty minutes an occasional tremulous inspir- 
ation took place, not unlike that of a child, after severe 
crying. While she was passsing through this ordeal my 
attention was so "invited to the spot" that I gave no 
attention to anything or anybody else; but after she got 
better I heard from an adjoining room the same sounds; 
the lady of the house was passing through the same kind 
of a proxysm. This was rather too much for my inquisitive 
nature to brook, without an investigation, so I ventured to 
ask: How long have you been subject to these attacks? 
The man of the house being present did not wait for his 
sister-in-law to answer, but promptly replied: Oh, a long 
time, every since they were girls, but they are growing 
worse, and we would give anything to have them cured; 
and our little girl there is begining to have them, pointing 
to a fair sharp featured, spare built child of eight years. 

I asked, how often do they come on ? He said, some- 
times they have five or six spells during the day; and 
again they go a week without having one. 

On further investigation 1 found that their mother had 
suffered from chorea ; that both ladies had suffered to some 
extent from these peculiar symj)toms ever since their 
menstruation had appeared ; that they were always worse 
when they had any particular care. Particularly about 
the approach of their menstrual periods ; that during 
pregnancy they were never troubled after the third or 
fourth month, nor during lactation did they ever complain. 

The history and symptoms of these cases pointed 
directly to uterine derangement, and I at once suggested a 
thorough examination of the uterus and its appendages. 
This suggestion was indignantly refused by both the ladies, 
saying, that they had always had good midwives to attend 
them, and that they, (the midwives) had told the best 
doctors in Kentucky about their cases, and no such propo- 
sition had ever been made before. 

During that year I was frequently called into the 



412 The Peoria Medical Monthly. 

family of each of these ladies, and of course became quite 
well acquainted, and the ladies finally got so they would 
talk to me of their own cases, and after many explanations 
and promises of secrecy, I was permitted to examine them. 
Each case presented a greatly retroverted uterus ; the 
cervix being tucked up behind the pubis and the fundus 
supinated against the rectum. 

There was a general relaxation of all the abdominal 
and perineal muscles, and an enlarged and tender con- 
dition of one ovary in each case. The cases being so 
exactly alike, a discription of one is also a discription of 
the other. Never were two cases of measles more com- 
pletely alike than these two cases of, "what do yoa call it?" 

The extreme modesty and timidity of these ladies 
materially interfered with their treatment, but I succeeded 
in straightening up the uterus in each case, and partially 
subduing the chronic inflammation of the ovaries, and their 
reflex nervous symptoms were greatly ameliorated, but 
before they entirely recovered they sold out their affects 
and returned to their former home in Kentucky. 

The little girl refered to above, who was said to be 
afflicted in the same way, was never examined, neither did 
I ever see her have a paroxysm ; therefore cannot say as to 
the nature of her case or its identity. But after what has 
been said of the history and symptoms of these cases, I 
think there are but few medical men, who will not agree 
with my diagnosis ; "hysteric spasm of the diaphragm" and 
also spasm of the muscles surrounding the glottis and the 
chordce vocalis. I regarded these cases as purely hysterical, 
and named them and treated them accordingly. 



Art. v.— Vinegar in Diarrhoea. By J. M. Adams, M. D., Noah, Indiana. 

I will report the following case. J. M. A., 64 years of 
age — has always had pretty fair health, except having had 
rheumatism more or less for the first half of his life ; has 
lost about all of his teeth except in front, so that mastica- 
tion is imperfectly performed. Was attacked Oct. 16, with 



I 



Book Notices. 413 

cholera morbus so violently that nothing appeared to do 
any good, and as cramp of the bowels came on, he submit- 
ted to a hypodermic injection of morphia and tinct. bella- 
donna which gave relief. The diarrhoea slowed up and in 
three or four days the patient appeared all right; but on 
the 22, the diarrhoea set in again more severely than ever. 
The appetite failed ; the contents of the bowels appeared 
to pour out like water, no nausea or thirst ; we used 
nearly all we could think of without any lasting benefit. 
Finally we used pinus canadensis by mouth and as an 
injection as directed by the "Rio Chemical Co." St. Louis, 
with an emulsion of gum acacia, turpentine and fine sugar 
three times per day, and hydrochloric acid with lacopeptine 
also three times a day ; still not much progress towards 
recovery. A strict hygenic diet was observed — this un- 
promising- condition continued for three or four days, 
sometimes better and then again worse until I looked over 
my Peoria Medical Monthly, and found on page 393 
strong cider vinegar recommended. I immediately ordered 
some and gave as directed and had no more trouble what- 
soever. We kept up the administration of sour drops 
and lactopeptine. Now, if any of you readers have ever 
tried vinegar, let us know, and any one having any criti- 
cism to offer let him do so. 



toofe %ti\\m. 



Medical Rhymes. A collection of Rhymes of ye Ancients time, and Rhymes of 
the Modern day, Rhymes Grave and Rhymes Mirthful, Rhymes Anatomical, 
Therapeutical and Surgical. All sorts of Rhymes to interest, amuse and 
edify all sorts of followers of Esculapius. Selected and compiled by a 
varietj'^ of sources. By Hugo Erichsen, M. D., etc., Detroit, Mich., with an 
introduction by Willis P. King, M. D., Sedalia, Mo. Illustrated, 8vo., cloth, 
pp. 220. J. H. Chambers & Co., St. Louis, Mo. 1884. Price $2.50. 

A book that will do the doctor as much good as a new 
work on practice, and more good than a dose of his own 
medicine. A book that will cause the doctor to laugh 
until his sides ache, and yet furnish food for serious 
thought. Why should not doctors not write verse ? (Some 



414- The Peoria Medical Monthly. 

of it in this volume rises to the real dignity of poetry.) No 
set of men are so well acquainted with all the foibles of 
human nature; no class of men see more of the pathetic 
side of humanity as well as the ludicroujs. Dr. King, in his 
introduction witily depicts the various positions the doctor 
holds on his community. In some localities the doctor 
must have a " professional smell " about him, as Dr. King 
says, " He is, perhaps the only being in the broad universe 
except the skunk and the billy-goat whom people expect to 
recognize by his peculiar odor " 

The first poem in the book entitled " With the Scalpel." 
by H. Saville Clarke, is one of the best. It begins : 

" Here's our subject tall and strong, 
With Termillion -well injected, 
Where the blood once coursed along, 
Ready now to be disected." 

The author's musings as to the past of the subject are 
poetically and gracefully expressed : 

" Here's a hand that once held fast 

All things pleasant, to ils liking. 

Now its active days are passed 

Or for friendship or for striking. 

Nothing colder here could lie, 
' Yet on some ones palm there lingers 

Sense of its warm touch, while I" 

Strip the fingers. 
•' How the dead eyes strangely stare 

When I lift the lids above them 

Yet some woman lives, I swear 

Who too well learnt to love them." 



But space forbids longer quotation. The well-known 
*' Lines to a Skeleton " are wisely included as well as 
Horace Smith's "Address to the'Mummy." 

Among the serious contemplative poems we note those 
by Dr. Oliver Wendell Holmes, on the "Good Physician," Dr. 
I. N. Himes, "The Doctor's Life," Dr. S. Weir Mitchell, "Lines 
to a Deserted Study," and anonymous lines from the Medical 
Bulletin, " To a Physician." Among the comic or sero-comic, 
which comprise the larger number in the volume, we 
would call attention to several, " The Primas Vise," by Dr. 



Book ISFotices. 415 

J. W. Poole, as one of the best sustained — parts of it are ex- 
ceedingly good. We quote : 

"Primse viae, ductus vitae 
Half thy stor}^ is unsung ; 
Uncongenial much that passes, 
Hydro-sulphurets and gasses, 
Fecal matters from thee wrung." 

"From the folds of deep mucosa 
Creep a thousand tiny rills; 
Bearing with them as they issue. 
Waste of nerve, debris of tissue, 
. Else the source of many ills." 

And the final stanza : 

"Primse vise, ductus vitse, , 

Let them scorn thy aid who can. 
Source of radiant health and beauty, 
I, my homage pay and duty — 
Thou it is thal|aiakes the man." 

Further on we find the " Ditty of the Doctor " by Dr. 
E. P. Davis, which will be remembered by readers of the 
Monthly. "A Modern Consultation " by the same writer 
lias been widely copied. 

" The Clinical Ditty of Fair Claribel " taken from the 
Lancet and Clinic, will cause a hearty laugh, and an em- 
phatic endorsement of the moral it points : 

"All country doctors are not graen, 
And some great menlack common sense." 

"Dr. Vitreous Browne and his Blue Glass," is good. Dr. 
Holmes' well-known " Stethoscopic Song " came in good 
place. The only poem that we think should have been 
left out is by Tennyson, entitled " In the Childrens' Hospi- 
tal." Its presence in a collection like this is but little 
short of an insult to the physician. We hope future edi- 
tions will be improved by its omission. There are so many 
good things, rich, racy things in the book that we are loath 
to refrain from further quotations, but our readers should 
send for it and enjoy them all as we have done. 

Typographically the book is a success, and the publish- 
ers should score a good mark on it. 



416 The Peoria Medical Monthly. 

Transactions of the 3Iedical and. Chirurgical Faculty of the State of Mary- 
hind. Eighty-sixth annual sessions held at Baltimore,Md., April, 1884; 8vo. 
paper, pages 248. Journal Publishing Co. 

The yearly volume of this society can always be relied 
upon to furnish a considerable number of good articles, 
and the present volume keeps up its reputa,tion. The an- 
nual address by Dr. Wm. Pepper, of Philadelphia, on Force 
vs. Work: some practical remarks on Dietetics in Disease, 
will be found replete with valuable suggestions, and is a 
really valuable contribution to the medical literature of 
the past year. 

The chairmen of the various sections have entered 
heartily into their work, and their reports are especially 
noticeable for their practical value. Elsewhere in this 
number of the Monthly, we have reprinted in full, the 
report on Materia Medica. The volunteer papers are num- 
erous and interesting, especially that of Dr. Geo. H. Rohe, 
on Certain Practical Points in the Pathologv, Clinical 
History and Treatment of Cancer. The society is certainly 
to be congratulated on its volume for this year. 

Transactions of the Colorado State Medical Society, in its Fourteenth Annual 

Convention, held in Denver, Col., June, 1884; Svo. paper, pages 156. 

One of the most important papers in this volume is 
that by Dr. H. A. Lemen, "A Contribution to Surgery, Re- 
port on a number of cases of Abdominal Section performed 
in this State for the relief of various diseased conditions 
and accidents," etc. 

Dr. S. E. Sally, of Colorado Springs, has an interesting 
paper on "Bright's Disease of the Kidneys as influenced by 
the Climate of Colorado." A number of climatic charts 
are included with the report of Dr. Chas. Denison, which 
will be of interest to those engaged in the study of climate 
and its effects on disease, especially pulmonary disease. 
Dr. Sears, of Leadville, recommends the intravenous 
injections of milk as a treatment for acute morphia pois- 
oning, with a report of two cases so treated. The volume 
gives evidence of a lively interest in medical matters by 
the physicians of Colorado. 

A Clinical Study of Syphilis of the Eye and its Appen- 
dages. 



Book Notices. 417 

Mumps a Cause of Sudden Deafness. 

Notes on the Treatment of Trachoma hy Jeqnirity. 

The above are reports of articles by Dr. Leartus Con- 
nor, of Detroit, Michigan. The first and second being 
taken from the American Journal of the Medical Sciences, 
and the third from the Detroit Lancet, of which Dr. Connor 
is the able editor. In the treatment of syphilis of the eye. 
Dr. Connor uses potassium iodide in large doses, to us, in 
some cases astoundingly large doses, as much as thirty 
grains being given every two hours for ten days. We have 
never yet seen a case that could take the iodide in such 
^oses, still Dr. Connor's success fully justifies the treatment 
and causes a wonder whether some of our own cases would 
not have been more sastisfactory had our treatment been 
more heroic. 

In the second monagraph the author brings up a 
'Comparatively unstudied subject, and collates thirty one 
cases of deafness following mumps. From the conclusions 
he draws, every physician should watch all patients 
afflicted with this disease, and attempt to prevent approach- 
ing deafness by revulsive, and counter irritant treatment. 
In the paper on jequirity in trachoma, the author gives 
the results of his own cases, as well as those of 800 cases in 
the hands of other observers, and concludes in brief, that 
jequirity is a valuable remedy in chronic trachoma or old 
corneal opacity from any cause, but "must not be 
employed if there be a suspicion of purulency complicating 
the disease." The strength he employs is the fresh, three 
per cent solution filtered. 

The Courier Revieiv Call Book. A Physician's Pocket 
Reference Book and Visiting List, arranged by Dr. E. M. 
Nelson, and published by J. H. Chambers & Co., St. Louis, 
Mo. Dr. Nelson has condensed an unusal amount of practi- 
cal matter, such as tables, etc., into twenty-six pages, and 
the blank pages are ruled to suit the requirements of 
any physician. 

Lindsay & Blackiston's Visiting List has reached the 
thirty-fourth year of publication, which fact alone speaks 



41 S The Peoria Medical Monthly.. 

more in its favor than anything we might write about ifc^ 
It fiill)^ deserves its popularity. 

The Medical Record Visiting List, published by Wm.. 
Wood »t Co., is certainly the most elegant in appearance of 
any that we have seen. Bound in seal, with gilt edges,. 
it appears to the esthetic sense of the physician, and that 
perhaps is one reason of its extensive use. It contains the 
usual tables, and blank pages, and is very cheap at the 
price ($1.50J at which it is sold. 



gm^rojre awtl gtbistrM. 



CONDUCTED BY DE. 0. B. WILL, PEORIA, ILL. 



The Effects of Alcohol Poisoning- on the Heart. 

Dr. A. S. Coe of Oswego, N. Y., addressed the following 
letter to the New York Medical Journal, on the above men- 
tioned very important subject : 

I have been forcibly impressed with the effects of alco- 
holic poison upon the action of the heart in several cases 
that have come under our observation — cases that gave no 
evidence of mental disturbance characteristic of mania a 
potu: The mind was clear and rational, save an expression 
of an overpowering sense of tear, of speedy dissolution.. 
The exhibition of anxiety, fear, and sometimes terror,, 
which no assurance from me could ally, was pitiable. This 
state ot mind is instinctive, due to the effect of alcoholic- 
poison upon the action of the heart. It is analogous to the 
overpowering sense of fear of impending dissolution ex- 
perienced in angina pectoris, and in the sudden paroxysms 
induced by fatty degeneration of the heart, but there is no 
dyspnoea or orthopna'a. The subjects had been drinking 
daily, for a long time, a large quantity of alcoholic stimu- 
lants, until the system had become thoroughly saturated 
and poisoned. The stomach was irritable and refused to 
retain food; the pulse small, thready, and intermittent;, 
the heart's action very irregular ; the sleep fitful and dis- 
turbed, the patients waking with a start, in a nervous^ 
tremor and abject terror, begging for more drink and in- 
sisting that they must have it or they would die. 



Periscope and Abstract. 419 

This thirst and craving for more drink are, in a great 
measure, due to the demand of the flagging heart for sup- 
port to enable it to continue its work ; the demand is im- 
perative, hence the instinctive sense of fear, amounting to, 
in some cases, abject terror. A heart-stimulant and re- 
storative soon appeases the desire for more stimulus and 
allays the fear. I found that nitro-glycerin, one one-hun- 
dreth of a grain, given every half hour or hour, soon stead- 
ied the pulse and gave strength and uniformity to the 
heart's action, and caused the importunate demand for 
more alcoholic stimulus and the abject fear to cease. The 
effect was almost immediate ; the pulse soon became full 
and steady, and the heart restored to its rhythmic action ; 
the face soon became flushed, and they complained of a 
sense of cerebral fullness, which soon passed off. 

October 22d, about 1 p. m., I was hastily called to visit 
Mr. D., a resident of the western part of the state, who was 
here on business, and had, he told me, been drinking 
during the past three weeks, on the average, fifteen glasses 
of lager beer a day, winding up each night on a half-pint of 
whiskey to procure sleep. He had vomited twice that 
morniog, felt very weak and nervous, and said that he 
feared he would not live long. His pulse w^as small, feeble 
and intermittent ; the heart's action was very irregular. 
I gave him one-third of a gallon of sulphate of morphine, 
and prescribed thirty grains of bromide of potassium, to be 
taken every fourth hour, well diluted with water, until 
sleep w^as induced, and ordered a bowl of beef-tea to be 
taken at intervals as his stomach could retain it. I also 
ordered entire abstinence from alcoholic stimulus, and 
trusted to a friend who was with him to see that the order 
Tvas obeyed. 

I called again about 6 p. m., and found him exceedingly 
nervous and depressed, more alarmed as to his recovery, 
and insisting that his wife should be sent for. His pulse- 
was a little more steady. He had taken advantage of a 
brief absence of his friend, and slipped down below and 
taken two drinks of whiskey at the bar, and had vomited 
some oyster-broth whice he had taken in place of the beef- 
tea. [ ordered a continuance of the bromide of potassium, . 
and left one-fourth of a grain of sulphate of morphine, to 
be taken in the night if sleep was not obtained. He had 
had about two and a half hours of fitful, disturbed sleep. 
in the afternoon. 

I called the next morning at eight, and found him in a. 
deplorable condition ; he w^as in a violent nervous tremor,^ 



420 The Peoria Medical Monthly. 

the pulse feeble and intermittent ; he was sure that he 
would not live much longer, and insisted that his wife 
should be sent for immediately. His friend told me that 
he had two intervals of sleep of about two hours and a 
half each, waking up each time in a nervous, frightened 
state and begging for more stimulus, which he had refused 
to give him ; he had vomited the morphine and bromide 
of potassium. I immediately gave him an ounce of whisky 
and a pill of nitro-glycerin. I remained by him about an 
hour ; his pulse immediately began to gain strength, full- 
ness, and steadiness, which continued about half an hour, 
and it then began to grow weak and unsteady. I then 
gave him another pill, which soon restored the strength 
and evenness of the pulse, and he ceased his abject en- 
treaties for more whisky, which up to that time had been 
almost constant, and expressed no more fear of dying. 
His stomach remained irritable through the day ; he was 
only able to retain small quantities of iced milk ; the pills 
were repeated every second hour until the afternoon, when 
they were discontinued, as his pulse had recovered from its 
weakness and irregularity. He was able to return to his 
home the next day. 

An acquaintance, of unusual strength and vigor of 
constitution, has studied the effects of alcoholism upon his 
own person ; it invariably causes an irregular and inter- 
mittent pulse and irregular action of the heart, but se"ldom 
affects his brain. 



Early Symptoms of Cancer. 



As Emeritus Professor, Professor of Clinical Surgery, 
Mr. Hutchinson is now delivering his second annual course 
of lectures at the London Hospital. This cojjrse was in- 
stituted last year on the occasion of Mr. Hutchinson's re- 
tirement from the acting surgical staff, when he was ap- 
pointed consulting surgeon, ft was considered desirable 
to retain him as a teacher in connection with the Medical 
College, so he was made Emeritus Professor, and undertook 
to deliver six lectures annually on some subject connected 
. with surgery. 

The lectures for the present year are perhaps a greater 
success than those given last summer, and being wholly 
delivered extempore appeal more directly to the minds of 
the auditors, it goes without saying that Mr. Hutchinson 
gives no mere summary of ordinary text-book opinions. 



Periscope and Abstract. 421 

but lays before his hearers, in plain and unmistakable 
terms, the results of his own clinical experience. 

On Wednesday, July 2d, a ^ood audience assembled 
to hear the lectures on " The Early Recognition of Cancer." 
The term "cancer" was used in its clinical sense and as 
including sarcoma, and not in its limited anatomical sense 
applying solely to carcinomatous growths. The iftiport- 
ance of its early recognition was obvious. Mr. Hutchinson 
said that before the actual presence of cancer, was what 
might be termed the pre-cancerous stage, and this was es- 
sentially a condition manifested by signs of local inflam- 
mation. An interesting case was narrated in support of 
this view. It was that of an old gentleman whom Mr. 
Hutchinson saw in consultation some years ago. One 
testicle had enlarged and was slowly increasing in size. 
The surgeons who saw the case agreed that it was probably 
not malignant and recommended non-interference. It con- 
tinued to grow, however, and was at last removed solely by 
request ot the patient, who had all along been anxious 
about it lest it should be cancerous. It was examined 
microscopically and was found to be simply in a condition 
of inflammatory hyperplasia, and no signs whatever of 
malignancy were discoverable. The patient recovered from 
the operation, no further trouble manifested itself, and his 
medical attendants came to the conclusion that his testi- 
cle had been unnecessarily removed, Two years elapsed. 
The remaining testicle then began to enlarge in the same 
way in which the other had done. Remembering the re- 
sult of the previous operation, the surgeons strongly ad- 
vised the patient against operation. As before, it continued 
to enlarge until finally it reached a considerable size. At 
last even the surgeon began to be alarmed and the patient's 
anxiety was extreme. The testicle was at last removed at 
the urgent request of the patient. It was examined and 
proved to contain a well marked sarcomatous growth. 
The inference was that the one first removed would, if al- 
lowed to remain, have also acquired a sarcomatous struct- 
ure, and that the inflammatory hyperplasia found was a 
condition leading up to that of actual malignancy. 

Eczema of the nipple preceding cancer was an illus- 
tration. Mr. Hutchinson remarked that cancer attacked 
parts that were functionally dead, as the breast in women 
late in lite. Among animals it attacked the cat, the dog, 
and the horse, but not the sheep. The two former animals 
led a lazy life and were allowed to drag out their existence 



422 The Peoria Medical Monthly. 

to old age. Sheep were usually killed before they were old 
enough to develop cancer. 

The practical conclusion Mr. Hutchinson drew from 
his view was to treat as cancer all those cases where you 
suspected it — to adopt active measures at once and not 
wait for more decided symptoms until it might be too late. 
— Med. Record. 



Remedies and Their Present Use. 

In calling the attention of the faculty to the remedies 
herein mentioned, it is not the design of the reporter to 
embrace al/ the many therapeutic agents, which have been 
brought to the notice of the profession within the year, but 
simply to select such as have proved especially efficacious 
and worthy of trial and commendation. 

SaJicjflate of Iron is a purplish salt, resembling the hue 
imported to the urine of patients who have taken either 
salicylic acid or the salicylate of sodium for some time, by 
adding a few drops of the solution of the chloride of iron, 
forming, in fact, this very salt. 

It seems to have done service in rheumatism after the 
heat and pain had yielded to the free use of the salicylate 
of sodium and the wine of colchicum. 

This salt of iron is selected in the affection referred to 
for its therapeutic action, and in the hope of keeping up 
gently the effect of salicylic acid, at the same time to 
secure the tonic effects of the iron in the anaemic condition 
attending convalescence from a severe attack of rheuma- 
tism. 

Being insoluble, the salt is preferably administered in 
capsule.s. as it forms an unsightly pill or powder. It pos- 
sesses the advantages over the acid in not producing the 
dryness of throat, and in its freedom from causing nausea. 
It appears as good a chalylieate as the reduced iron, and 
does not produce the vascular excitement or headache as 
do most of the preparations of iron when kept for any 
length of time. 

It has been administered for several days, in S grain 
do'ses, 3 times daily, without producing the buzzing in the 
ears, so characteristic of sodium salicylate or of quinine. 

I/f/dri otic Acid, in the form of the stable syrup of hy- 
driodic acid, is growing into favor as a remedy in spas- 
modic asthma, and was first suggested by Dr. Buchanan, 
of^Jlasgow. Scotland, wlio imagined he ought to obtain the 
effects of iodoform soonest in this form, and yet avoid the 



Periscope and Abstract. 423 

irritation of the stomach and the offensive taste of the 
crude drug, as well as overcome the likelihood of produc- 
ing frontal and nasal catarrh, to which so many individ- 
uals are liable from taking the iodine in any form. How- 
ever this may be, this syrup is certainly efficacious in some 
cases of asthma when other remedies fail, and it appears 
to stand next in promptness of relief to the i grain hypo- 
dermic injection of morphia sulphate, which, though almost 
sure to lessen the paroxysm, is so fascinating to the patient 
as to render its habit liable to be contracted. The syrup 
can be used with comparative freedom, that is from 30 
drops to the full drachm in the adult asthmatic. A good 
plan is to relieve the immoderate seizure with the morphia, 
and at once begin with 30 drops of the syrup. The form 
now on the market is Gardner's. It should be a permanent 
preparation, more so than the syrup of the iodine of iron, 
and may be resorted to whenever the effects of iodine are 
desirable, though it is especially recommended in asthma. 
It seems to act just as did large doses of the potassium 
iodide some twenty years ago, and many patients claim to 
have derived more benefit therefrom in 20 grain doses than 
from any of the "many agents so much praised in this 
disease. It has been suggested to administer this syrup in 
some starchy emulsion, but surely this would be a poor 
vehicle from the likelihood to form an inert iodide of starch. 

This syrup should contain about one per cent, ot ab- 
solute hydriodic acid, and should have a sp. gr. of 1,300. 

It gives better results by far than the grindelia, and 
even better than a mixture of equal parts of the fluid ex- 
tract of the grindelia and the syrup of garlic, which 
affords much and prompt relief in many cases. 

A Syrup of the Bromide of Nickel is coming into use in 
i to 1 drachm doses. It is a green syrup, like in color to 
the liquid used in the show windows of drug stores, and 
which is. a solution simply of the sulphate of the metal. 
The syrup of the bromide has hardly been used long 
enough to warrant any favorable comments. 

The Saccharated Oil of the Saw Palmetto is said to be 
useful in indigestion and in vomiting, acting like Ingluvin 
and Pepsin in relieving irritability of stomach. It appears 
.to act on the mucous membranes generally, preventing 
purulent discharges from the nose and pharynx, as well as 
diminishing the excessive 'spnta of phthisis. It is given 
in drachm doses, three times a day, while the same amount 
may be added to half a pint of warm water for purposes of 



424 The Peoria Medical Monthly. 

inhalation. Tiiis preparation is said to act on the mucous 
surfaces just as the fluid extract of the pinus canadensis. 

Citric Acid, in drachm doses, in the form of a lemon- 
ade, has been followed by wonderfully good results in 
metrorrhagia. It was first suggested to a member of this 
committee by the apparent benefit derived from drinking 
strong lemonade in the case of a lady with lacerated 
cervix. 

Coumarin, the supposed active principle of the Tonka 
bean, is now being used to disguise the odor of iodoform, 
and it is about as effective in that particular as the many 
agents suggested for that purpose, as balsam Peru, roasted 
coffee, mint, etc. Indeed, a few of the Tonka beans kept 
in the iodoform bottle will very sensibly lessen the dis- 
agreeable smell. This coumarin appears to be a paralyzing 
agent to the heart in the lower animals. Vanillin, from 
the vanilla bean, acts in the same way. Tonka bean enters 
into the proprietary medicine, tongaline, which is some- 
times useful in allaying the agonies of facial and frontal 
neuralgia, but the efficacy is probably owing to the salicyl- 
ate of sodium and the colchicin and the pilocarpine which 
enters into its formation. 

Lozenges of Chloroclyne, containing about two drops of 
the fluid, act well in irritable throat, in enlarged and irrita- 
ble tonsils, in elongated uvula, and in the form of pharyn- 
geal irritation, so unfavorable to sleep. Not being unpleas- 
ant to the taste, they are capable of doing much good in 
slight cases. 

Chloral Hi/drate, in some patients, produces such de- 
pressing effects that it seems worth while calling the atten- 
tion of physicians to the fact that even free doses of this 
drug may be advantageously combined with the tincture 
of digitalis and given in a tonic tincture, as the compound 
tincture of bark or the compound tincture of gentian, with- 
out producing the unpleasant symptoms referred to. We 
may safely give as many drops of the digitalis tincture as 
we give grains of the chloral, the tonic and the digitalis 
both serving to stay the heart's action without lessening 
the hypnotic effects. 

Pelleficrine, the alkaloid of the pomegranate, Granatum 
Punica bark, both of the root and stem, has for some time 
been sold as a powder, having been prepared in Paris and 
sent to this country. In 1878, Tanret reported the discov- 
ery of this principle, suggesting for it the name of pellet- 
ierina, after the great chemist Pelletier, after whom a 
street is also called in the French capital. This agent is 



Periscope and Abstract. 425 

alkaloid of the pomegranate, just as quinine and cincho- 
idia are alkaloids of the peruvian bark. 

It appears sometimes as a syrup like the syrup made 
from the maple sugar. Being the isolated active agent of 
the fresh bark of the root, it is useful against tape worm, 
but while it can be given in small doses, it is questionable 
if it is more effective than the strong decoction of the fresh 
bark given freely. We are thus sure ot what we are using, 
and subjecting the patient to far less cost than in using 
the imported article. By the previous withholding of food, 
except milk, perhaps, from the patient for a day, and the 
washing out of the bowels freely with an ounce of Rochelle 
salts, or better still, by a few doses of the black draught, 
we are pretty sure of the expulsion of the greater portion, 
or the whole of the worm, from the combination of one 
to two drachms, of the oleoresin of the male fern, with or 
without turpentine, given in a pint of the pomegranate 
tea, and followed up in six hours by a good dose of castor 
oil, with turpentine, say half an ounce of the latter. 

Dr. Laboulliene, who has specially studied the subject, 
expressed the wish that the active agent of the pomegran- 
ate bark might be isolated, and Monsieur Tanret received 
for this discovery the prize awarded by the Academy of 
Sciences. 

In hospital service this alkaloid has given decided sat- 
isfaction, furnishing 32 successes in 33 cases in which it 
was used, and by Prof. Laboulliene himself it was success- 
ful in all 15 cases where he used it in January and Feb- 
ruary, 1880. This taenicide should be given while segments 
of the worm are being passed, which occurs in most sub- 
jects once in three months, until the head is expelled. A 
full injection (lavement) is given, and the patient put on 
milk diet, and next morning the medicine is given in 
sweetened water, and after waiting a quarter of an hour, 
an ounce dose (30 grammes) of the compound tincture of 
jalap is given to purge freely. 

Nysten calls the pomegranate a specific against this 
form of worm, and Mons. Bourdier succeeded with sulph- 
uric ether one drachm, in a tea made of the male fern, fol- 
lowing it very soon after with an injection. At the end of 
one hour he administered two ounces of castor oil, and this 
he repeated every third day, unless the worm had pre- 
viously been expelled. 

The syrup of Pelletier causes the same giddiness as 
seen after full doses of the decoction of the bark root. In 
using the tea for chronic dysentery, it is not given in quan- 



426 The Peoria Medical Monthly. 

tity sufficient to cause giddiness. The pomegranate, male 
fern, pumpkin seeds, or the koosso, neither of them cause 
the expulsion of the worm, but serve to render it torpid 
and feeble, so that a xevy active purge will complete the 
treatment. 

Boracic Acid, freel}^ used as a wash in erysipelas, has 
been followed by good results. It is not irritating to the 
inflamed skin axid allays the itching, and may be injected 
into cavities and tistulae. The strong solution in hot water 
is better than the ointment, because coming more directly 
in contact. Lister's antiseptic ointment is made of boric 
acid 1 part, white wax 1 part, parafine and the oil of sweet 
almonds, each, 2 parts. The antiseptic sold as Listerine 
contains this acid. 

Phosphate Codeine is useful for hypodermic administra- 
tion because of its great solubility. 1 part of the salt to 4 
of water. 100 parts of the phosphate contain 70 parts of 
the codeine. 

Jequiriti/ Seeds (Abrus Precatorius) are now being used 
in granular troubles of the eyelids, destroying the granu- 
lations by the profuse purulent discharge which it occasions. 
This is often painful in the extreme. An infusion is used 
as a wash for the interior of the lids, of the strength of 1 
to 25. The seeds are hard, about J of an inch long, and 
occur in a pod about J of an inch long. The plant is 
leguminous, indigenous to Africa and South America. The 
color of the seeds is brilliant scarlet, the chief character- 
istic being a black spot around the hilum. 

Pheno-Resorcin is prepared by mixing resorcin, carbolic 
acid and water, which forms a permanent liquid. The 
resorcin is said to be less poisonous than carbolic acid, and 
has been recommended in diabetes mellitus in 1 grain 
doses. 

J\traldeh)jde has been found to be antagonistic to the 
effects of strychnia, and hence has been suggested as an 
antidote in poisoning from this powerful alkaloid. Dr. 
('laiborne, of Petersburg, Va., found large doses of camphor 
antagonize the poisonous effects of strychnine in experi- 
ments which he made on dog;^. His conclusion was that 
about IT) grains of camphor destroyed the action of 1 grain 
of strychnia. 

Nitrate Vraninni has received attention as beneficial in 
the treatment of dial^etes mellitus. Dr. Dale, of Lemon t, 
Pennsylvania, praises it as having been very efficient in 
his hands, in one grain doses, three times daily; but Prof. 
Tyson, of JMiiladelphia, does not ascribe much good to its 



Periscope and Abstract. 427 

action. Lactic acid in doses just short of producing pains 
in the joints and muscles resembling rheumatism, has been 
followed hy remarkable effects in lessening the amount of 
sugar in urine. From 75 to 150 grains of the acid, given 
during the 24 hours in water, is the plan suggested by 
Cantani. Glycerine, too, for the same purpose, has been 
recommended, using it in place of sugar; and Senator sug- 
gests that the fatty acids be given in this disease, and for 
this purpose he gave pills of soap 2i grains each; of these 
4 were to be taken 3 times a day. This plan did not pro- 
duce digestive troubles, though continued for several weeks. 
In one instance he added cod liver oil, and while the patient 
increased in weight 11 ounces in 14 days, there was little 
or no lessening of the amount of sugar excreted. Dilute 
phosphoric acid has done much good in this disease. 

Croton Oil — ol. crot. tiglii — has been separated into two 
parts, the one purgative but non- vesicating, while the se- 
cond is non-purgative but vesicating. This has been shown 
by investigations by Harold Seiner, of England, within the 
past few months. 

Kairin is a product of coal tar by a patent process. 
Prof. Fischer, of Munich, first prepared it, and obtained 
the patent for his process. This agent is claimed to possess 
all the antipyretic properties of quinine, with none of its 
secondary unpleasant effects. It may be used in about the 
same dose. 

Ichthyol is a product obtained from a bituminous min- 
eral in Switizerland, and is recommended by Dr. Unna, of 
Hamburg, as a prompt remedy in some skin affections. 

Fonnanide of Mercury has been suggested as a substi- 
tute for the corrosive chloride for obtaining the constitu- 
tional action of this metal by hypodermic use. — Dr. A. 
Atkinson, Trans. Med. and Chir. Faculty of Md. 



A New Symptom of Tubercular Meningitis. 

Dr. Lambert Ott has recently signalized, as a symptom 
of tubercular meningitis, the extreme sensibility com- 
plained of by the patient when pressure is made over the 
surface of the femur ; a fact which, although accidentally 
discovered in examining a case, he has been able to verify 
in a second case where pressure over other parts of the 
body excited no pain whatever. 

The mention of this clinical sign, which the Paris 
Medical extracts from the Phila. Med. Times, brings to our 



428 The Peoria Medical Monthly. 

recoUectioii a clinical lecture of Mon. Lasegue, in which 
the Professor insisted upon its diagnostic value and cited 
three dases, remarkably confirmatory of his conclusion. 
In a first case, called to see a young girl presenting symp- 
toms of meningitis — which, moreover, was confirmed later 
— Mon. Lasegue discovered, while exploring the cutaneous 
surface, an extreme sensibility over the region of the thigh. 
At the moment he used even a moderate degree of pressure, 
the patient uttered a cry of pain, while no hyperesthesia 
was present in any other region of the body. 

In another patient the pain was not so severe, still it 
was present in no inconsiderable degree. Finally, in a 
female twenty years of age, attacked with fever, violent 
headache and delirium, this sign was quite pronounced, as 
the patient was aroused from a semi-comatose condition 
and became conocisus of severe suffering as soon as pressure 
was made on the thighs. 

Mons. Lasegue was forcibly reminded of these several 
cases occuring in his practice apropos to the condition of 
a young girl who entered his service suffering from deaf- 
ness, prostration, and stupor, without any intestinal or 
thoracic difficulty, and who presented this phenomenon in 
a marked degree. At the moment this explanation was 
made the patient gave evidence of suffering very different 
from that experienced in muscular rheumatism. 

In view of these facts M. Lasegue concludes that this 
symptom, conjoined with others, is a valuable aid in con- 
firming a diagnosis of cerebral or meningeal troubles. 

In support of this view, we may mention that Dr. 
Fournier cites a case of a young man, suffering from 
cerebro-meningitis which was rapidly fatal — in which this 
pain excited by pressure over the thigh was present in a 
high degree of intensity. In this patient, treated by MM. 
Fournier, Charcot, and Edward Labbe, the pain was so 
severe that these gentlemen at several different times 
made a careful search to ascertain whether there was not 
present some local trouble in the form of periostitis, ostitis, 
or abscess independent of the cerebral affection. 

A careful examination failed to give any explanation 
or clue to local difficulty. 

With a view of calling attention to the apparent con- 
nection between the meningeal trouble and the pains 
referred to M. Fournier proposed to designate them as 
''cerebral pain of the exfremities'^ until a more satisfactory 
idea can be formed of the real pathogeny — Columbus Med. 
Journal. 



Periscope and Abstract. 429 

Hydrochlorate of Cocaine as a Local Anaesthetic in Grynecology.- 

As a matter of some interest, just at this time, I give 
the results obtained with hydrochlorate of cocaine in two 
cases of trachelorrhaphy done this afternoon (October 29^ 
1881) 

Case 1. Double laceration of the cervix uteri, extending 
on both sides to cervico-vaginal junction. — The vagina was 
first washed with a warm water douche, then the cervix, 
the patulous cervical canal, and the vaginal w^alls adjoin- 
ing the cervix were carefully washed with Castile soap^ 
this in turn was washed off, and the surface carefully dried. 
Next a four per cent, solution was painted over the cervix, 
in the canal, and over the adjacent vaginal wall with a 
camel's-hair brush. This was repeated twice, at intervals 
of two to three minutes, making 3 applications of the drug. 
Within three minutes of the last application the operation 
was begun. 

It required the removal of extensive pieces of cicatri- 
cial tissue from each angle, making it an elaborate opera- 
tion of its kind. The time consumed was about forty 
minutes, the patient made no complaint and suffered no 
pain till the last ten minutes ot the procedure, then she 
spoke of her discomfort as being a sense of soreness rather 
than acute pain. 

Thinking that the case might be one of those in which 
the normal sensitiveness of the region was not great, conse- 
quently one that might have borne the operation without 
the use of angesthetic, local or general, I chose a second. 

Case 2. The woman was one having less selt-control 
than the first, and with a good deal of normal sensitiveness 
about the uterus and vagina. The preparation of the 
region and the application of the anaesthetic was the same 
as in Case 1. 

No pain was felt till the lapse of about twenty minutes, 
then it was so acute as to require an application of the 
solution of cocaine, making in her the fourth. In three 
minutes the operation was continued and soon completed 
without further pain. This last application was made 
directly to the cut surfaces, first freeing them from blood. 

The patient, who three years ago had had the same 
operation performed under ether, was asked which method 
she preferred, that with ether or this last without; she 
promptly replied, this last. 

In the first case the effect of the drug seemed to be 
that it not only blunted sensibility, but it appeared to 
retard the first appearance of blood upon the cut surface. 



430 The Peoria Medical Monthly. 

These cases I offer as a contribution to the solution of 
the question now so prominently before the profession — 
the phice to be held b}" hydrochlorate of cocaine as a local 
anaesthetic. With a view of testing its value in obstetric 
practice a series of observations are being made in the 
Emergency Hospital, the* solution being applied to the 
cervix and the upper part of the vagina during the severe 
pains of the tirst stage of labor. The result I beg leave to 
communicate to you when the number of cases are large 
enough to make the report valuable. — W. M. Folk, M. D., 
in Med. Becord. 



Hemorrhoids. 

The treatment of hemorrhoids constitutes no inconsider- 
able item in the general practitioners work and those who 
hesitate to inject the mass with the various proportions of 
gl3^cerine and carbolic acid for fear of embolism, or who do 
not like to resort to the actual cautery, or the fuming nit- 
ric acid, will welcome the results of the plan recommended 
by M. Verneuil. Before making the quotation, which 
comes from the Medical Age, we call the attention to the 
necessity of uncomplicated measures both in pharmacy 
and surgery. In all cases where the hemorrhoids are either 
injected with carbolic acid, or subjected to actual cautery 
or touched with fuming nitric acid, the sphincter is previ- 
ously stretched, and whilst the advantage has been hither- 
to attributed to the acid or the heat, we now receive the 
assurance that the stretching of the sphincter is all that 
is required. 

"M. Charles Monod has written to the Gazette de Hop- 
itaur, an article on a new treatment of strangulated 
hemorrhoids which he has x>ut into practice with the 
greatest success. This treatment consists in forcibly dilat- 
ing the anus, as in case of fissure. M. Verneuil has already 
recommended this method for the cure of simple piles, and 
has been followed by most of the young surgeons, who 
have entirely abandoned every other treatment. To effect 
the dilation, M. Verneuil employed specula of different 
dimensions, and only in the case, as has been just stated, 
of the ordinary condition of hemorrhoids. On the con- 
trary, he says that "when the piles are the seat of sphace- 
lus he always waited until the complication disappeared." 
M. Monod, who has imitated M. Verneuil with the best 
results in those simple cases, goes sUH farther, and instead 
of regarrJing strangulation as a counter-indication to the 
operation, considers that this fact renders it the more 



Periscope and Abstract. 431 

necessary. He cites a case in point. He was called by 
•one of his confreres to see a gentleman who had been 
suffering excruciating agony for two days from strangu- 
lated piles, and on whom ice fomentations, narcotics intus 
and extra were tried without effect. Local examination 
showed no more than is ordinary in such cases — a ring of 
tumefied external hemorrhoids, with a dark spot in the 
centre, announcing the commencing ol sphacelus. The 
least touch was painful, and the patient demanded relief 
at any price. Partisan of the treatment of hemorrhoids in 
general by dilatation, he thought that he would be doing 
right in employing it in the present case, knowing that by 
supressing the general action of the sphincter the pain 
would cease. Accordingly, the patient was put under the 
influence of chloroform, and the hemorrhoidal tumors 
reduced, aud M. Monod largely dilated the anus with his 
fingers. A few minutes afterwards the patient aw^oke free 
from all pain, and in a few days he had the satisfaction of 
not only feeling that the strangulation had entirely disap- 
peared, but that he was forever quit of the piles. This 
case of Monod's proves that the hand dilates just as well 
as the speculum, and consequently the operation "is reduced 
to its simplest expression. — Medical Revieiv. 



The Surgical and Orthopedic Treatment of Infantile Paralysis. 

Bernard Roth, F. R. C. S., in a paper read before the 
British Medical Association {British Medical Journal,) gives 
special attention to the use of massage and movements, 
both voluntary and iuvoluntar, in the treatment of infantile 
paralysis after the acute stage has passed, to improve the 
power of those affected muscles which have still some 
voluntary power left; and to prevent the onset of any 
deformity, or, if this has already occurred, to reduce it to a 
minimum. The first thing done is to correct the lowering 
of temperature, nearly always present, of the limb or limbs. 
If one leg is affected, the parents should be told not to be 
satisfied unless it is as warm as the healthy one; quick 
sponging with tepid water, good rubbing and drying, and 
extra clothing, such as loosely knitted woolen stockings, 
thick cloth leggins, or, best of all cloth leggins lined with 
cat skin or other fur. Baths 98-100^ F. for 10-20 minutes 
every evening. A small barrel on end answers admirably. 
This to be followed by a rapid sponging of the whole body 
with cold water. 

Massage more frequently an hour twice daily by knead- 



432 The Peoria Medical Monthly. 

ing, a combiuation of grasping, and large pinching and 
pressure, with the two hands used alternately, one after the 
other, so that whatever is left of the wasted muscle 
is thorough!}' squeezed and moved about. The skin is to 
be protected from abrasion by lubrication with olive oil, or 
vaseline. 

Circular friction hy the thiimh is done as follows: The 
operator's thumb-end is firmly placed on any given spot, 
and while considerable pressure is exerted, describes small 
circles, ten tilnes from right to left and ten times from left 
to right. A spot an inch higher or lower, or to one side, is 
then treated in the same way, and so on until every part 
of the muscle has been thoroughly manipulated. 

Fulling acts less directly on the muscles, but rather on 
the whole of the tissues of the paralytic limb; it is affected 
by rapid to-and-fro alternate gliding of the two palms on 
opposite sides of the limb, which is at the same time as 
firmly compressed as possible. If the leg is to be "fulled,'^ 
the operator begins close to the groin and gradually w^orks 
his way down to the foot, moving the hands rapidly to and 
fro the w^hole time. The first time, the hands should be 
on the outer and inner aspect of the leg; the next, they 
should be placed higher on one side and lower on the other; 
the third time, this position is reversed; and finally, the 
hands are placed posteriorly and anteriorly to the limb. 
After five minutes of such manipulation a dozen or two 
firm stroJiings-douii of the leg end the rubbing. 

With this the so-called Swedish exercises or medical 
gyrnnastics makes the treatment complete. The latter 
varies according to the part to be influenced and consists 
in making each muscle or group of muscles contract and 
then gradually relax, at first actively and then against 
resistance by the surgeon. With the hip-joint the patient 
lies prone and raises the leg, with the knee kept extended, 
froin off the ground — if too weak, the hand under the knee 
assists the movement. Circumduction follows of the hip 
from right to left, and vice versa, ten or twelve times each 
way — its severity being increased by pressure of the hand 
against the back of the heel. Knee-joint. Here the 

Eatient lying supine has the knees flexed, and the legs 
anging vertically over the end of the padded table on 
which he lies, and exercises the extensors by slowly 
extending one knee, when too weak the foot is supported. 
AnUe-Joint. Here the leg is supported on a chair, the foot 
projecting; flexion, extension, adduction, abduction and 
circumduction are executed either voluntarily by the 



Pfeiscope and Abstract. 433 

patient or passively by the surgeon. The shoulder-joint. 
Tiie patient lying on the back, circumduction from before 
backwards, the elbow and wrist being kept extended vol- 
untarily or by a wooden splint. To bring the scapular 
muscles into action, the patient, lying supine, with the 
arms down by the side of the trunk, or abducted at right 
angles to the body, or extended upwards by the side of the 
head, is told to resist the arms being brought forward from 
either of the above positions, and then voluntarily returned 
to the initial position against gradually yielding resistance. 
Elbow-joint The upper aim being fixed against the table, 
flexion or extension is easily resisted by the hand. 
Throughout all these exercises, care should be taken that, 
while the patient is trying to contract, he is prevented 
involuntarily contracting other stronger or normal muscles 
which should be kept at rest. 

He further recommends to equalize the length of the 
two legs where one has become shortened, by a thicker 
sole on the boot of the shorter, to bandage the sound arm 
to the side for some hours daily, where one arm only is 
paralyzed, and to stop at once all unnatural modes of 
progression. It the toes are much deformed, stockings 
with toes will be found efiicacious. Suspenders and never 
•garters should be worn. Milk entering largely into the 
food, tepid water enemata on alternate days, and fresh air 
several hours daily, complete in brief, his mode of 
treatment. 



Early Recognition of Tabes Dorsalis. 

The early recognition of this difiiculty is a matter of 
the most supreme importance. Dr. Julius Althaus thus 
expressed himself relative to his mode of investigation: 

"At the initial period of the second stage of tabes a 
skilled objective exploration of the patient's condition is of 
paramount importance. The subjective symptoms of 
which he most complains are often misleading and com- 
paratively insignificant; while the principal objective sign 
is often so concealed that only the specially trained 
observer is able to recognize and appreciate it. At this 
time, a patient may still be able to walk four or five rniles 
at a time without much fatigue, and often scouts the idea 
that there is any thing wrong with his walking powers. 
It is, therefore, necessary to make him go through a certain 
number of tests, some or all of which, when ataxy is 
present, will infallibly reveal it. The more important of 



434 The Peori